A modified Delphi process to determine surgical COVID-19 research priorities: PRODUCE study

Background: With the current COVID-19 global pandemic causing major disruption to surgical services and acute surgical care worldwide, there is a need for international collaboration to determine the most pressing COVID-19 related surgical research priorities. The aim of this study was to use a modified Delphi process to determine these, to ensure high-quality research in the future. Method: Surgical stakeholders (multidisciplinary healthcare professionals and patients) were invited by email using surgical society membership details or Twitter to submit individual research questions via an online survey (phase I). Two rounds of prioritisation by stakeholders (phase II and III) were then completed to determine a final list of research questions. All questions were analysed on an anonymised basis. Results: A total of 510 questions were submitted by 130 stakeholders in phase I. Of these, 96 questions were taken forward for prioritisation in phase II, which was completed by 213 stakeholders. Following Phase II analysis, 216 stakeholders prioritised 39 questions in Phase III, resulting in a final list of 13 focused questions. Stakeholders were predominantly general surgeons but included clinical-scientists and patients from over 50 countries. Conclusion: The study has identified 13 key research priorities relating to surgery during the COVID-19 pandemic. Funding applications, to establish well-designed, high-quality international collaborative research outcomes are now required to address these questions as a matter of urgency.