Research Prioritization (SMARTER)

In 2014, the University of Washington BOLD team received an award from the independent nonprofit Patient-Centered Outcomes Research Institute (PCORI) to conduct a research project to identify the most effective ways to involve patients in the beginning stages of medical research – specifically in identifying the research agenda and prioritizing research topics for action. Historically, the patient voice has been missing in this initial stage of research design. As a result, what matters most to patients may not have been reflected in research studies. The project team reached out to BOLD Registry participants at Kaiser Permanente, Northern California and Henry Ford Health System in Detroit, Michigan, to take part in a research study that would help us learn more about how to involve patients in identifying topics for research.

As a first step, we mailed BOLD Registry participants at Kaiser and Henry Ford a list of previously identified topics for back pain research. This list had been complied by clinicians treating back pain patients. We asked BOLD participants at Kaiser and Henry Ford to tell us what they thought were the most important topics for research based on this previously generated list. Participants were also invited to add new topics to the list they thought were missing but important.
924 individuals participated, and the end result was a new list of research priorities, generated by patients with back pain. The final top priorities identified were:

  1. What are the causes of low back pain?
  2. What are the most effective self-care strategies for treating and managing low back pain?
  3. What are effective tests to diagnose the causes of different types of low back pain?
  4. What are the best strategies for putting research results into clinical practice?
  5. Which physical health programs work best to help people experiencing different types of low back pain?
  6. How can we best organize primary care services to become more effective in treating low back pain?
  7. How can low back pain disability be reduced?
  8. What patient characteristics and medical care factors predict a good response to treatment for low back pain?
  9. What are the most effective ways to provide primary care patients with information?
  10. What are the most effective strategies for improving physician communication and counseling skills when working with patients experiencing low back pain?
  11. How do different treatments for low back pain compare with regards to effectiveness and safety?
  12. What role does weight control and exercise play in treating low back pain?
  13. What role can Cognitive Behavioral Therapy, or counseling to help people manage stress, play in the treatment and management of low back pain?

As a follow-up to this initial activity, we asked individuals if they were interested in taking part in a second phase of our work, by participating in an in-person focus group, completing additional mailed surveys, or participating in an online community. This phase of our work will help us further explore different ways to involve patients in identifying and prioritizing research topics allowing for more interaction between people.

Do you have personal experience with back pain, or experience caring for someone with back pain? We need your expertise! Contact us to learn how you can get involved.