Emergency general surgery (EGS) patients account for more than one-third of admissions to hospitals in the National Health Service (NHS) in England. The associated mortality of these patients has been quoted as approximately eight times higher than that of elective surgical admissions. This study used a modified Delphi approach to identify research priorities in EGS. The aim was to establish a research agenda using a formal consensus-based approach in an effort to identify questions relevant to EGS that could ultimately guide research to improve outcomes for this cohort. Three rounds were conducted using an electronic questionnaire and involved health care professionals, research personnel, patients and their relatives. In the first round, stakeholders were invited to submit clinical research questions that they felt were priorities for future research. In rounds two and three, participants were asked to score individual questions in order of priority using a 5-point Likert scale. Between rounds, an expert panel analysed results before forwarding questions to subsequent rounds. Ninety-two EGS research questions were proposed in Phase 1. Following the first round of prioritisation, forty-seven questions progressed to the final phase. A final list of seventeen research questions were identified from the final round of prioritisation, categorised as condition-specific questions of high interest within general EGS, emergency colorectal surgery, non-technical and health services research. A broad range of research questions were identified including questions on peri-operative strategies, EGS outcomes in older patients, as well as non-technical and technical influences on EGS outcomes. Our study provides a consensus delivered framework that should determine the research agenda for future EGS projects. It may also assist setting priorities for research funding and multi-centre collaborative strategies within the academic clinical interest of EGS.

中文翻译：

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急诊普通外科（EGS）的研究重点：改进的德尔菲方法

急诊普通外科 (EGS) 患者占英格兰国家卫生服务 (NHS) 医院入院人数的三分之一以上。这些患者的相关死亡率被引用为大约是择期手术入院的八倍。本研究使用改进的 Delphi 方法来确定 EGS 的研究重点。目的是使用基于共识的正式方法建立研究议程，以努力确定与 EGS 相关的问题，这些问题最终可以指导研究以改善该队列的结果。使用电子问卷进行了三轮调查，涉及医疗保健专业人员、研究人员、患者及其亲属。在第一轮，利益相关者被邀请提交他们认为是未来研究重点的临床研究问题。在第二轮和第三轮中，参与者被要求使用 5 点李克特量表按优先顺序对各个问题进行评分。在轮次之间，专家小组在将问题转发到后续轮次之前分析结果。第一阶段提出了 92 个 EGS 研究问题。在第一轮优先排序之后，有 47 个问题进入最后阶段。从最后一轮优先排序中确定了 17 个研究问题的最终列表，分类为一般 EGS、紧急结直肠手术、非技术和卫生服务研究中高度关注的特定条件问题。确定了广泛的研究问题，包括围手术期策略、老年患者的 EGS 结果以及对 EGS 结果的非技术和技术影响的问题。我们的研究提供了一个共识框架，应该确定未来 EGS 项目的研究议程。它还可能有助于在 EGS 的学术临床兴趣范围内确定研究资金和多中心合作战略的优先事项。