Transcript James Lind Alliance Working Partnership on Urinary

James Lind Alliance
Working Partnership
on Urinary Incontinence
James Lind Alliance Working Partnership on Urinary Incontinence
Tallon et al 2000
• Consulted rheumatologists, physiotherapists,
GPs & patients
• What they most often sought information &
evidence on re. treatment of osteoarthritis of
the knee
• Compared with published research evidence
Lancet 2000; 355: 2037–40
James Lind Alliance Working Partnership on Urinary Incontinence
Rheumatologists:
Indications & outcomes re. knee replacement
Physiotherapists:
Outcomes of replacement & exercise-based Tx
GPs:
Success rates of surgery;
Conservative Tx - exercise & education
Patients:
Conservative Tx;
Self-help, coping strategies, aids
James Lind Alliance Working Partnership on Urinary Incontinence
RCTs:
• 83% = drug treatments, 5% surgery
All commercially funded research:
• 89% = drug treatments, 4% = surgery
“If this mismatch is not addressed, then
evidence-based medicine will not be
representative of consumer needs”
Lind J. A treatise on the scurvy. In three parts. Containing
an inquiry into the nature, causes and cure of that
disease. Together with a critical and chronological view
of what has been published on the subject. Edinburgh:
Printed by Sands, Murray and Cochran for A Kincaid
and A Donaldson; 1753.
James Lind Alliance
• Established by Iain Chalmers
• Aims to bring together clinician &
patient organisations in “Working
Partnerships”
• To identify & prioritise questions of
everyday clinical importance not
adequately answered by existing
research evidence
• Reporting to MRC and NHS HTA
programme
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Consultation
Collation
Prioritisation
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Identification of potential partner organisations
Exploratory meeting
Consultation
Collation
Prioritisation
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Positive responses as at 30/3/07
Alzheimer's Society
Association for Continence Advice
Association of Chartered Physiotherapist in Women's Health
Association for Spina Bifida and Hydrocephalus
British Association of Urological Nurses
British Association of Urological Surgeons
British Geriatrics Society
British Society of Urogynaecology
Continence Foundation
Cystitis & Overactive Bladder Foundation
InContact
Multiple Sclerosis Trust
Pelvic Pain Support Network
Disabled Living Foundation
Royal College of Nurses Continence Care Forum
Royal College of Obstetricians and Gynaecologists
Spinal Injuries Association
UCAN - Academic Urology Unit
Urostomy Association
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Identification of potential partner organisations
Exploratory meeting
Consultation
Collation
Prioritisation
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Consultation
Harvesting questions from members
Existing sources: question-answering
resources, research recommendations
Collation
Prioritisation
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Consultation
Collation
Qs gathered, categorised, combined & refined
Existing evidence base checked by C.I.G.
Remainder formed into clear research Qs
Prioritisation
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Consultation
Collation
Prioritisation
Prioritisation of research Qs thru consensus
Methods informed by asthma WP
Reporting
James Lind Alliance Working Partnership on Urinary Incontinence
Initiation
Consultation
Collation
Prioritisation
Reporting
Schedule of prioritised Qs to MRC & NHS HTA
programme and published
Resulting funding applications at advantage?
James Lind Alliance Working Partnership on Urinary Incontinence
Thanks to…
• Prof Adrian Grant, Sir Iain Chalmers, Dr Alex
Greene, Jude Frankau, Lester Firkins, Sally
Crowe
• Medical Research Council, NHS HTA
Programme, NHS R&D Programme,
Cochrane Collaboration, Association of
Medical Research Charities, Royal Society of
Medicine, INVOLVE