Priority setting is important in terms of allocation of research funding, and has the potential to ensure that all stakeholders play a role in identifying the research agenda of an organisation. In the case of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network, it will allow the network to assess whether or not a trial applying for endorsement meets the criteria for endorsement in that it satisfies an ANZMUSC research priority (reflecting important disease burden and an important evidence – or evidence- practice gap).

There are many alternate ways of developing a priority list including the Delphi method (iterative consultation with stakeholders and experts), trend analysis and modelling (using previous trends to predict future burdens), scenario discussion (assessment of priorities via structured discussion of outcomes and matrix approaches (using quantifiable data such as cost-effectiveness to consider the potential effect). While methods such as the James Lind Alliance approach is worthy in some situations, the list it creates is not dynamic and may be biased by the participants involved in the task.

To over come these issues, ANZMUSC will be undertaking a multi-attribute decision making process as described below.

• Web-Survey of ANZMUSC members
• Workshop format of clinicians and consumers to identify contemporary clinical issues that participants would like addressed by research
• Review of Therapeutic Guidelines: Rheumatology, 3rd edition to identify recommendations that were made based upon either low quality evidence or consensus
• Review of all Cochrane reviews relating to MSK conditions (mostly published by Cochrane Musculoskeletal and Cochrane Back) to identify where implications for research included the need for further high quality evidence
• Review of MSK questions produced by previous priority setting projects internationally.
• Review of Choosing Wisely and like initiatives such as EVOLVE for MSK conditions to identify evidence-practice gaps

A systematic review of other MSK priority setting exercises has been conducted and published in the BMJ Open.

IMPLICATIONS OF THE ANZMUSC PRIORITY LIST OF RESEARCH QUESTIONS:

Based upon the development of a transparent method of ranking the importance of research questions that we can apply to a large list of MSK research questions identified from a variety of sources, we will generate an ANZMUSC Priority list of research questions.

It is important to note that this list will not preclude researchers submitting proposals that address different, and also potentially important questions, that might rank higher than questions generated in this exercise. It is also possible that ANZMUSC itself, or the CAG might subsequently identify new research questions that are also ranked high in importance. Therefore, this list of potentially important MSK research questions should be considered dynamic and evolving.