A European Research Agenda for Geriatric Emergency Medicine: a modified Delphi study

Simon P Mooijaart^{1

2}, Christian H Nickel³, Simon P Conroy⁴, Jacinta A Lucke^{5

6}, Lisa S van Tol⁵, Mareline Olthof⁵, Laura C Blomaard⁵, Bianca M Buurman⁷, Zerrin D Dundar⁸, Bas de Groot⁹, Beatrice Gasperini¹⁰, Pieter Heeren^{11

12

13}, Mehmet A Karamercan¹⁴, Rosa McNamara¹⁵, Aine Mitchell¹⁶, James D van Oppen^{4

17}, F Javier Martin Sanchez¹⁸, Yvonne Schoon¹⁹, Katrin Singler²⁰, Renan Spode²¹, Sigrun Skúldóttir^{22

23}, Thordis Thorrsteindottir²², Marije van der Velde²⁴, James Wallace²⁵

Affiliations

¹ Department of Gerontology and Geriatrics, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands. S.P.Mooijaart@lumc.nl.
² Institute for Evidence-Based Medicine for Older People (IEMO), Leiden, The Netherlands. S.P.Mooijaart@lumc.nl.
³ Department of Emergency Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
⁴ Department of Health Sciences, University of Leicester, Leicester, UK.
⁵ Department of Gerontology and Geriatrics, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands.
⁶ Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
⁷ Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁸ Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
⁹ Department of Emergency Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
¹⁰ Department of Geriatrics and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano, Italy.
¹¹ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
¹² Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
¹³ Research Foundation-Flanders (FWO), Brussels, Belgium.
¹⁴ Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.
¹⁵ Department of Emergency Medicine, St. Vincent University Hospital, Dublin, Ireland.
¹⁶ Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland.
¹⁷ Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
¹⁸ Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.
¹⁹ Department of Emergency Medicine and Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
²⁰ Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.
²¹ Department of Emergency Medicine, Charité University Hospital, Berlin, Germany.
²² Research Institute in Emergency Care, Landspitali National University Hospital of Iceland, Reykjavík, Iceland.
²³ The Icelandic Gerontological Research Institute, Reykjavík, Iceland.
²⁴ Department of Geriatrics, Amphia Hospital, Breda, The Netherlands.
²⁵ Emergency Department, Warrington and Halton Hospitals NHS Teaching Trust, Warrington, England, UK.

PMID: 33219983
PMCID: PMC7990812
DOI: 10.1007/s41999-020-00426-8

A European Research Agenda for Geriatric Emergency Medicine: a modified Delphi study

Simon P Mooijaart et al. Eur Geriatr Med. 2021 Apr.

. 2021 Apr;12(2):413-422.

doi: 10.1007/s41999-020-00426-8. Epub 2020 Nov 21.

Authors

Affiliations

¹ Department of Gerontology and Geriatrics, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands. S.P.Mooijaart@lumc.nl.
² Institute for Evidence-Based Medicine for Older People (IEMO), Leiden, The Netherlands. S.P.Mooijaart@lumc.nl.
³ Department of Emergency Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
⁴ Department of Health Sciences, University of Leicester, Leicester, UK.
⁵ Department of Gerontology and Geriatrics, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands.
⁶ Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
⁷ Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁸ Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
⁹ Department of Emergency Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
¹⁰ Department of Geriatrics and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano, Italy.
¹¹ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
¹² Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
¹³ Research Foundation-Flanders (FWO), Brussels, Belgium.
¹⁴ Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.
¹⁵ Department of Emergency Medicine, St. Vincent University Hospital, Dublin, Ireland.
¹⁶ Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland.
¹⁷ Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
¹⁸ Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.
¹⁹ Department of Emergency Medicine and Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
²⁰ Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.
²¹ Department of Emergency Medicine, Charité University Hospital, Berlin, Germany.
²² Research Institute in Emergency Care, Landspitali National University Hospital of Iceland, Reykjavík, Iceland.
²³ The Icelandic Gerontological Research Institute, Reykjavík, Iceland.
²⁴ Department of Geriatrics, Amphia Hospital, Breda, The Netherlands.
²⁵ Emergency Department, Warrington and Halton Hospitals NHS Teaching Trust, Warrington, England, UK.

PMID: 33219983
PMCID: PMC7990812
DOI: 10.1007/s41999-020-00426-8

Abstract

Purpose: Geriatric Emergency Medicine (GEM) focuses on delivering optimal care to (sub)acutely ill older people. This involves a multidisciplinary approach throughout the whole healthcare chain. However, the underpinning evidence base is weak and it is unclear which research questions have the highest priority. The aim of this study was to provide an inventory and prioritisation of research questions among GEM professionals throughout Europe.

Methods: A two-stage modified Delphi approach was used. In stage 1, an online survey was administered to various professionals working in GEM both in the Emergency Department (ED) and other healthcare settings throughout Europe to make an inventory of potential research questions. In the processing phase, research questions were screened, categorised, and validated by an expert panel. Subsequently, in stage 2, remaining research questions were ranked based on relevance using a second online survey administered to the same target population, to identify the top 10 prioritised research questions.

Results: In response to the first survey, 145 respondents submitted 233 potential research questions. A total of 61 research questions were included in the second stage, which was completed by 176 respondents. The question with the highest priority was: Is implementation of elements of CGA (comprehensive geriatric assessment), such as screening for frailty and geriatric interventions, effective in improving outcomes for older patients in the ED?

Conclusion: This study presents a top 10 of high-priority research questions for a European Research Agenda for Geriatric Emergency Medicine. The list of research questions may serve as guidance for researchers, policymakers and funding bodies in prioritising future research projects.

Keywords: Geriatric Emergency Medicine; Research prioritisation.

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Conflict of interest statement

Lead authors are chairs of the Geriatric Emergency Medicine special interest group of the European Society for Geriatric Medicine (SPM) and the Geriatric Emergency Medicine section of the European Society for Emergency Medicine (CHN and JAL). On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

**Fig. 1**
Overview of research process in order to gain insight into the knowledge gap in the field of Geriatric Emergency Medicine by conducting two modified Delphi stages

**Fig. 2**
Flowchart representing the screening and categorization process (processing phase I) and the validation (processing phase II) of the received inputs resulting from the first online survey of stage 1

See this image and copyright information in PMC

References

1. Melady D. Geriatric emergency medicine: research priorities to respond to "The Silver Boom". Cjem. 2018;20(3):327–328. doi: 10.1017/cem.2018.397. - DOI - PubMed
1. EUSEM. Updated definition of Emergency Medicine in Europe 2017. https://eusem.org/news/87-updated-definition-of-emergency-medicine-in-eu.... Accessed 05 Mar 2020
1. Quinn TJ, Mooijaart SP, Gallacher K, Burton JK. Acute care assessment of older adults living with frailty. BMJ. 2019;364:l13. doi: 10.1136/bmj.l13. - DOI - PubMed
1. Carpenter CR, Heard K, Wilber S, Ginde AA, Stiffler K, Gerson LW, et al. Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad Emerg Med. 2011;18(6):644–654. doi: 10.1111/j.1553-2712.2011.01092.x. - DOI - PMC - PubMed
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A European Research Agenda for Geriatric Emergency Medicine: a modified Delphi study

Affiliations

A European Research Agenda for Geriatric Emergency Medicine: a modified Delphi study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials