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Using a modified nominal group technique to develop complex interventions for a randomised controlled trial in children with symptomatic pes planus
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Backhouse, Michael R., Parker, Daniel J., Morison, Stewart C., Anderson, Jenny, Cockayne, Sarah and Adamson, Joy A. (2022) Using a modified nominal group technique to develop complex interventions for a randomised controlled trial in children with symptomatic pes planus. Trials, 23 (1). doi:10.1186/s13063-022-06251-7
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Official URL: http://dx.doi.org/10.1186/s13063-022-06251-7
Abstract
Background
Children with symptomatic flat feet (pes planus) frequently present for care but there remains uncertainty about how best to manage their condition. There is considerable variation in practice between and within professions. We intend to conduct a three-arm trial to evaluate three frequently used interventions for pes planus (exercise and advice, exercise and advice plus prefabricated orthoses, and exercise and advice plus custom made orthoses). Each of these interventions are complex and required developing prior to starting the trial. This paper focusses on the development process undertaken to develop the interventions.
Methods
We used a modified Nominal Group Technique combining an electronic survey with two face-to-face meetings to achieve consensus on the final logic model and menu of options for each intervention. Using the Nominal Group Technique across consecutive meetings in combination with a questionnaire is novel, and enabled us to develop complex interventions that reflect contemporary clinical practice.
Results
In total 16 healthcare professionals took part in the consensus. These consisted of 11 podiatrists, two orthotists, two physiotherapists, and one orthopaedic surgeon.
Both meetings endorsed the logic model with amendments to reflect the wider psychosocial impact of pes planus and its treatment, as well as the increasing use of shared decision making in practice. Short lists of options were agreed for prefabricated and custom made orthoses, structures to target in stretching and strengthening exercises, and elements of health education and advice.
Conclusions
Our novel modification of the nominal group technique produced a coherent logic model and shortlist of options for each of the interventions that explicitly enable adaptability. We formed a consensus on the range of what is permissible within each intervention so that their integrity is kept intact and they can be adapted and pragmatically applied. The process of combining survey data with face-to-face meetings has ensured the interventions mirror contemporary practice and may provide a template for other trials.
| Item Type: | Journal Item | ||||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RD Surgery |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Flatfoot, Foot -- Abnormalities, Clinical trials , Foot -- Abnormalities -- Treatment | ||||||||
| Journal or Publication Title: | Trials | ||||||||
| Publisher: | Biomed Central | ||||||||
| ISSN: | 1745-6215 | ||||||||
| Official Date: | 11 April 2022 | ||||||||
| Dates: |
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| Volume: | 23 | ||||||||
| Number: | 1 | ||||||||
| Number of Pages: | 8 | ||||||||
| DOI: | 10.1186/s13063-022-06251-7 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 19 April 2022 | ||||||||
| Date of first compliant Open Access: | 19 April 2022 | ||||||||
| RIOXX Funder/Project Grant: |
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