Prioritising unanswered research questions in obstetrics and gynaecology. A systematic review

Abstract

AB Objectives: Despite the escalation in research activity and an exponential rise in published papers, many of the fundamental questions in obstetrics and gynaecology remain. A prioritised list of unanswered research questions developed to specifically highlight the most pressing clinical needs as perceived by professionals, researchers, and patients should inform future research priorities. Awareness of completed priority setting initiatives is in our speciality is low. Therefore, we undertook a systematic review of studies prioritising unanswered research questions in obstetrics and gynaecology. Method: We searched bibliographical databases, including CENTRAL, Embase, and MEDLINE, from 2007 to February 2018. Studies prioritising unanswered research questions in obstetrics and gynaecology were included. Two researchers independently assessed studies for inclusion, evaluated methodological quality, and extracted relevant data. We used descriptive statistics to characterise the included studies, summarise methodological quality, and demonstrate the feasibility of prioritised unanswered research questions. Results: Eight studies were included. All studies were conducted in higher resource settings. Two studies have prioritised unanswered research questions in gynaecology and six studies have prioritised unanswered research questions in obstetrics. The quantitative, qualitative, and consensus methods used to prioritise unanswered research questions varied considerably. Methodological quality varied considerably limitations including poor reporting of consensus science methods, prioritised unanswered research questions which could not be addressed within a research setting, and limited involvement of patients. Conclusions: Prioritising unanswered research questions should ensure future research has the necessary reach and relevance to inform future clinical practice and improve clinical outcomes. However, the impact of such initiatives can be muted if the consultation is inadequate, robust consensus science methods are not used, and the final research uncertainties are poorly constructed. We are drowning in research that is singularly lacking in impact. We need fewer but better studies.