Use of consensus development to establish national research priorities in critical care

Objectives To test the Feasibility of using a nominal group technique to es tablish clinical and health services research priorities in critical care a nd to test the representativeness of the group's views. Design Generation of topics by means of a national survey a nominal group t echnique to establish the level of consensus: a survey to test the represen tativeness of the results. Setting United Kingdom and Republic of Ireland. Subjects Nominal group composed of 10 doctors (8 consultants, 2 trainees) a nd 2 nurses. Main outcome measure Level of support (median) and level of agreement (mean absolute deviation from the median) derived from a 9 point Likert scale. Results Of the 325 intensive care units approached. 187 (58%) responded, pr oviding about 1000 suggestions for research Of the 106 most frequently sugg ested topics considered by the nominal group. 37 attracted strong support. 48 moderate support and 21 weak support. There was more agreement after the group had met-overall mean of the mean absolute deviations from the median fell from 1.41 to 1.26. The group's views represented the views of the wid er community of critical care staff (r = 0.73, P < 0.01). There was no sign ificant difference in the views of staff from teaching or from non-teaching hospitals. Of the 37 topics that attracted the strongest support, 24 were concerned with organisational aspects of critical care and only 13 with tec hnology assessment or clinical research. Conclusions A nominal group technique is feasible and reliable for determin ing research priorities among clinicians. This approach is more democratic and transparent than the traditional methods used by research funding bodie s. The results suggest that clinicians perceive research into the best ways of delivering and organising services as a high priority.