Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.

<h4>Background</h4>Serious illness is characterised by uncertainty, particularly in older age groups. Uncertainty may be experienced by patients, family carers, and health professionals about a broad variety of issues. There are many evidence gaps regarding the experience and management...

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Main Authors: Simon N Etkind, Stephen Barclay, Anna Spathis, Sarah A Hopkins, Ben Bowers, Jonathan Koffman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0289522&type=printable
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author Simon N Etkind
Stephen Barclay
Anna Spathis
Sarah A Hopkins
Ben Bowers
Jonathan Koffman
author_facet Simon N Etkind
Stephen Barclay
Anna Spathis
Sarah A Hopkins
Ben Bowers
Jonathan Koffman
author_sort Simon N Etkind
collection DOAJ
description <h4>Background</h4>Serious illness is characterised by uncertainty, particularly in older age groups. Uncertainty may be experienced by patients, family carers, and health professionals about a broad variety of issues. There are many evidence gaps regarding the experience and management of uncertainty.<h4>Aim</h4>We aimed to identify priority research areas concerning uncertainty in serious illness, to ensure that future research better meets the needs of those affected by uncertainty and reduce research inefficiencies.<h4>Methods</h4>Rapid prioritisation workshop comprising five focus groups to identify research areas, followed by a ranking exercise to prioritise them. Participants were healthcare professionals caring for those with serious illnesses including geriatrics, palliative care, intensive care; researchers; patient/carer representatives, and policymakers. Descriptive analysis of ranking data and qualitative framework analysis of focus group transcripts was undertaken.<h4>Results</h4>Thirty-four participants took part; 67% female, mean age 47 (range 33-67). The highest priority was communication of uncertainty, ranked first by 15 participants (overall ranking score 1.59/3). Subsequent priorities were: 2) How to cope with uncertainty; 3) healthcare professional education/training; 4) Optimising clinical approaches to uncertainty; and 5) exploring in-depth experiences of uncertainty. Research questions regarding optimal management of uncertainty were given higher priority than questions about experiences of uncertainty and its impact.<h4>Conclusions</h4>These co-produced, clinically-focused research priorities map out key evidence gaps concerning uncertainty in serious illness. Managing uncertainty is the most pressing issue, and researchers should prioritise how to optimally manage uncertainty in order to reduce distress, unlock decision paralysis and improve illness and care experience.
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spelling doaj.art-8ef6a58590f9432796d926aec441aba92024-03-12T05:31:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01192e028952210.1371/journal.pone.0289522Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.Simon N EtkindStephen BarclayAnna SpathisSarah A HopkinsBen BowersJonathan Koffman<h4>Background</h4>Serious illness is characterised by uncertainty, particularly in older age groups. Uncertainty may be experienced by patients, family carers, and health professionals about a broad variety of issues. There are many evidence gaps regarding the experience and management of uncertainty.<h4>Aim</h4>We aimed to identify priority research areas concerning uncertainty in serious illness, to ensure that future research better meets the needs of those affected by uncertainty and reduce research inefficiencies.<h4>Methods</h4>Rapid prioritisation workshop comprising five focus groups to identify research areas, followed by a ranking exercise to prioritise them. Participants were healthcare professionals caring for those with serious illnesses including geriatrics, palliative care, intensive care; researchers; patient/carer representatives, and policymakers. Descriptive analysis of ranking data and qualitative framework analysis of focus group transcripts was undertaken.<h4>Results</h4>Thirty-four participants took part; 67% female, mean age 47 (range 33-67). The highest priority was communication of uncertainty, ranked first by 15 participants (overall ranking score 1.59/3). Subsequent priorities were: 2) How to cope with uncertainty; 3) healthcare professional education/training; 4) Optimising clinical approaches to uncertainty; and 5) exploring in-depth experiences of uncertainty. Research questions regarding optimal management of uncertainty were given higher priority than questions about experiences of uncertainty and its impact.<h4>Conclusions</h4>These co-produced, clinically-focused research priorities map out key evidence gaps concerning uncertainty in serious illness. Managing uncertainty is the most pressing issue, and researchers should prioritise how to optimally manage uncertainty in order to reduce distress, unlock decision paralysis and improve illness and care experience.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0289522&type=printable
spellingShingle Simon N Etkind
Stephen Barclay
Anna Spathis
Sarah A Hopkins
Ben Bowers
Jonathan Koffman
Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
PLoS ONE
title Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
title_full Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
title_fullStr Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
title_full_unstemmed Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
title_short Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.
title_sort uncertainty in serious illness a national interdisciplinary consensus exercise to identify clinical research priorities
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0289522&type=printable
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