• research, clinical
• methods
• emergency department
• clinical

Emergency medicine is such a broad specialty, and the research underway and planned in emergency medicine such a vast undertaking, that we need to focus on the most important research questions to answer the most pressing clinical dilemmas. Funding for research is limited, and competition for money is fierce. It therefore is imperative that as a specialty we define the most important questions, to find the answers, to improve the clinical care our patients receive. The people who should be involved in defining these questions must include the clinicians working in our emergency departments, and our patients and their carers.

Over the coming months, a research priority setting process will take place, to establish what the most important research questions are to clinicians working in the specialty of emergency medicine, and also to the patients we serve. The Royal College of Emergency Medicine, in partnership with the James Lind Alliance (JLA), will be conducting a research priority setting partnership, involving clinicians, patients and carers.

A research prioritisation process is important for several reasons. Academic emergency medicine is a relatively young specialty, and as such is at somewhat of a disadvantage when compared with some of the larger and better-resourced academic powerhouses. When submitting grant applications as part of open or researcher-led calls, we are competing with other specialties for funding, and often coming off worse.

Large research grant awarding bodies look to specialties to provide evidence of the need for research on particular topics. Why should they fund one project over another? On whose say should one topic be of more importance than the next?

The most powerful way to conduct a process of prioritisation involves not only those doing the research, but also clinicians in that specialty, and in particular the users of the service, in other words, our patients and their carers.

The JLA1 is an organisation co-located with and managed by the National Institute of Health Research Evaluation, Trials and Studies Coordinating Centre in Southampton, UK, and they bring together clinicians, patients, and other stakeholders in partnership to set research priorities. They aim to identify unanswered questions within a specialty, and rank them in order of priority, with the final output from the priority setting partnership (PSP) being a ‘top 10’ of research priorities for that given area. The advantage of the JLA is that they provide a framework, with a reproducible process, and advisers who guide the process along the way. They are recognised as the gold standard in research prioritisation. This means that if you are applying for a research grant, and can map your application to one of the research priorities, then this adds considerable weight to the application. While the process will be undertaken in the UK, many of the research questions that are generated by the process will be generalisable across the boundaries of international emergency medicine.

The process is a significant undertaking, is likely to take 18 months to 2 years to complete, and involves several phases. Initially, a broad invitation is distributed to contribute research questions, among members of the emergency medicine community including patient groups and carer organisations. Several different tools, including social media, will be used to encourage involvement of all the key stakeholder groups.

Then the research ideas are scrutinised to formulate defined questions. A literature review will be undertaken to establish whether there is already an answer to a research question within the existing literature. This will be one of the most time-consuming and labour-intensive phases of the process, but will produce a series of mini-systematic reviews, along the lines of BestBETs,2 which in itself will be a useful resource for clinicians in the specialty. Those questions that have not already been answered will go forward to a prioritisation process, initially electronically, and then once there is a shortlist, a final summary meeting will be held to establish top 10 research priorities for the specialty.

This PSP will embed a process for research prioritisation into the emergency medicine community, and will allow us to stand toe to toe with our larger and longer established academic cousins. This is our chance to influence the research that happens in our specialty over the next decade. We urge you all to participate.