A consensus building exercise to determine research priorities for silver trauma
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RESEARCH ARTICLE
Open Access
A consensus building exercise to determine research priorities for silver trauma Abdullah Alshibani1,2, Jay Banerjee1,3, Fiona Lecky4, Timothy J. Coats5, Rebecca Prest3, Áine Mitchell6, Emily Laithwaite3, Matt Wensley3 and Simon Conroy1*
Abstract Background: Emergency care research into ‘Silver Trauma’, which is simply defined as major trauma consequent upon relatively minor injury mechanisms, is facing many challenges including that at present, there is no clear prioritisation of the issues. This study aimed to determine the top research priorities to guide future research. Methods: This consensus-based prioritization exercise used a three-stage modified Delphi technique. The study consisted of an idea generating (divergent) first round, a ranking evaluation in the second round, and a (convergent) consensus meeting in the third round. Results: A total of 20 research questions advanced to the final round of this study. After discussing the importance and clinical significance of each research question, five research questions were prioritised by the experts; the top three research priorities were: (1). What are older people’s preferred goals of trauma care? (2). Beyond the Emergency Department (ED), what is the appropriate combined geriatric and trauma care? (3). Do older adults benefit from access to trauma centres? If so, do older trauma patients have equitable access to trauma centre compared to younger adults? Conclusion: The results of this study will assist clinicians, researchers, and organisations that are interested in silver trauma in guiding their future efforts and funding toward addressing the identified research priorities. Keywords: Injury, Geriatrics, Older adults, Emergency, Prehospital, Research questions, Trauma, Triage
Background ‘Silver Trauma’ is major trauma consequent upon relatively minor injury mechanisms, commonly seen in older people. As the population of older adults is increasing worldwide [1, 2], so will rates of silver trauma. Emergency and prehospital care represent central parts of a trauma patients’ care journey, and play major roles in determining their outcomes [3–5]. The growth of the silver trauma population has resulted in increased demand * Correspondence: [email protected] 1 Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester LE1 7HA, UK Full list of author information is available at the end of the article
to provide the optimal level of emergency care which, in turn, requires more evidence-based practice for the treatment and management of this population. However, research into silver trauma is not extensive and many research questions remain unanswered [6, 7]. Furthermore, it is unclear which outcomes might be valued most by older people with silver trauma – whose priorities might well be different to working age population (the main beneficiaries of trauma research to date) [8, 9]. An effective way to determine research priorities in healthcare is to build consensus amongst clinicians. A well-recogni
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