Priority Setting Results (2019-2020)

We are pleased to present the initial results of Cochrane Anaeshesia's 2019-2020 priority setting exercise

This is the first formal priority-setting exercise we have completed as a Review Group. The plan is to complete this process every three years. We executed a multi-component process involving:

  • a public stakeholder survey
  • analysis and triage of our existing catalogue of review titles
  • input from our priority-setting steering committee and editorial boards

Data was collected and combined from these sources, and we informally ranked new and existing titles based on the following factors:

*Applied only to existing titles

Top 25 Priority Review Titles

The priority review titles for Cochrane Anaesthesia, selected for the period of 2020-2023 (mapped on to scope areas, in no particular order) are**:

Postoperative complications and how to avoid them

·       Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults

·       Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting

·       Sugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade

·       Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults

·       Interventions for treating inadvertent postoperative hypothermia

·       Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery

·       Epidural local anaesthetics versus opioid-based analgesic regimens for postoperative gastrointestinal paralysis, vomiting and pain after abdominal surgery

·       Alcohol cessation for postoperative complications

·       Pulmonary rehabilitation for people with respiratory disease (new title)

Airway management

·       Airway physical examination tests for detection of difficult airway management in apparently normal adult patients

·       Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

Perioperative mental health

·       Music interventions for preoperative anxiety

·       Preoperative screening for mental health conditions (new title)

·       Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia

Perioperative care

·       Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia

Regional anaesthesia

·       Hyperbaric versus isobaric bupivacaine for spinal anaesthesia for caesarean section

·       Paravertebral block versus thoracic epidural for patients undergoing thoracotomy

·       Anaesthesia for hip fracture surgery in adults

Intraoperative management

·       Continuation versus discontinuation of antiplatelet therapy for bleeding and ischaemic events in adults undergoing non-cardiac surgery

Pre-operative assessment, optimization, and health promotion

·       Preoperative carbohydrate treatment for enhancing recovery after elective surgery

·       Vapocoolants (cold spray) for pain treatment during intravenous cannulation

·       Rapid weight loss before surgery (new title)

·       Dietary advice programmes to improve weight control before surgery (new title)

·       Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults

Acute Pain Management

·       Intranasal fentanyl for the management of acute pain in children

Next Steps

This list of titles will be validated by our Review Group and priority setting steering group. All selected titles will be prioritized for initiation or updating. We will continue to register new titles (not listed), but the priority titles will be given precedence, barring exceptional circumstances. If existing author teams are unable to update their titles, we will place these titles as vacant, and new authors will be able to apply to take over.

We will share these results widely, both on our online and social media platforms, and directly with stakeholders. We will continuously assess the editorial effort and impact for these priority reviews. Also, we plan to dedicate additional resources to enhanced dissemination planning and impact monitoring for these titles.

**Due to the circumstances of the COVID-19 pandemic, we are expecting that more data on our existing portfolio may become available over the year. If new influential data is submitted, we may update or add to this list of titles. We will share these updates publicly. If you are an author of one of the listed titles, you should expect to hear from our editorial office in early 2021 regarding updating your review. If you are a CARG author and your review is not listed, but you are interested in updating your review, you can also get in touch to discuss options. You can read more about priority setting at Cochrane here.

You can download a PDF copy of these results here

If you have feedback on the priority setting process, these results, or questions about how we plan to handle these priority review titles, please contact the group’s Managing Editor Vernon Hedge vernon.paul.hedge@regionh.dk