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Background One of the top three research priorities for the UK clinical trial community is to address the gap in evidence-based approaches to improving participant retention in randomised trials. Despite this, there is little evidence supporting methods to improve retention. This paper reports the PRioRiTy II project, a Priority Setting Partnership (PSP) that identified and prioritised unanswered questions and uncertainties around trial retention in collaboration with key stakeholders. Methods This PSP was conducted in collaboration with the James Lind Alliance, a non-profit making initiative, to support key stakeholders (researchers, patients, and the public) in jointly identifying and agreeing on priority research questions. There were three stages. (1) First an initial online survey was conducted consisting of six open-ended questions about retention in randomised trials. Responses were coded into thematic groups to create a longlist of questions. The longlist of questions was checked against existing evidence to ensure that they had not been answered by existing research. (2) An interim stage involved a further online survey where stakeholders were asked to select questions of key importance from the longlist. (3) A face-to-face consensus meeting was held, where key stakeholder representatives agreed on an ordered list of 21 unanswered research questions for methods of improving retention in randomised trials. Results A total of 456 respondents yielded 2431 answers to six open-ended questions, from which 372 questions specifically about retention were identified. Further analysis included thematically grouping all data items within answers and merging questions in consultation with the Steering Group. This produced 27 questions for further rating during the interim survey. The top 21 questions from the interim online survey were brought to a face-to-face consensus meeting in which key stakeholder representatives prioritised the order. The ‘Top 10’ of these are reported in this paper. The number one ranked question was ’What motivates a participant’s decision to complete a clinical trial?’ The entire list will be available at www.priorityresearch.ie . Conclusion The Top 10 list can inform the direction of future research on trial methods and be used by funders to guide projects aiming to address and improve retention in randomised trials.

Background Despite the problem of inadequate recruitment to randomised trials, there is little evidence to guide researchers on decisions about how people are effectively recruited to take part in trials. The PRioRiTy study aimed to identify and prioritise important unanswered trial recruitment questions for research. The PRioRiTy study - Priority Setting Partnership (PSP) included members of the public approached to take part in a randomised trial or who have represented participants on randomised trial steering committees, health professionals and research staff with experience of recruiting to randomised trials, people who have designed, conducted, analysed or reported on randomised trials and people with experience of randomised trials methodology. Methods This partnership was aided by the James Lind Alliance and involved eight stages: (i) identifying a unique, relevant prioritisation area within trial methodology; (ii) establishing a steering group (iii) identifying and engaging with partners and stakeholders; (iv) formulating an initial list of uncertainties; (v) collating the uncertainties into research questions; (vi) confirming that the questions for research are a current recruitment challenge; (vii) shortlisting questions and (viii) final prioritisation through a face-to-face workshop. Results A total of 790 survey respondents yielded 1693 open-text answers to 6 questions, from which 1880 potential questions for research were identified. After merging duplicates, the number of questions was reduced to 496. Questions were combined further, and those that were submitted by fewer than 15 people and/or fewer than 6 of the 7 stakeholder groups were excluded from the next round of prioritisation resulting in 31 unique questions for research. All 31 questions were confirmed as being unanswered after checking relevant, up-to-date research evidence. The 10 highest priority questions were ranked at a face-to-face workshop. The number 1 ranked question was “How can randomised trials become part of routine care and best utilise current clinical care pathways?” The top 10 research questions can be viewed at www.priorityresearch.ie . Conclusion The prioritised questions call for a collective focus on normalising trials as part of clinical care, enhancing communication, addressing barriers, enablers and motivators around participation and exploring greater public involvement in the research process.

Rapid and automatic processing of grammatical complexity is argued to take place during speech comprehension, engaging a left-lateralized fronto-temporal language network. Here we address how neural activity in these regions is modulated by the grammatical properties of spoken words. We used combined magneto- and electroencephalography to delineate the spatiotemporal patterns of activity that support the recognition of morphologically complex words in English with inflectional (-s) and derivational (-er) affixes (e.g., bakes, baker). The mismatch negativity, an index of linguistic memory traces elicited in a passive listening paradigm, was used to examine the neural dynamics elicited by morphologically complex words. Results revealed an initial peak 130-180 ms after the deviation point with a major source in left superior temporal cortex. The localization of this early activation showed a sensitivity to two grammatical properties of the stimuli: (1) the presence of morphological complexity, with affixed words showing increased left-laterality compared to non-affixed words; and (2) the grammatical category, with affixed verbs showing greater left-lateralization in inferior frontal gyrus compared to affixed nouns (bakes vs. beaks). This automatic brain response was additionally sensitive to semantic coherence (the meaning of the stem vs. the meaning of the whole form) in left middle temporal cortex. These results demonstrate that the spatiotemporal pattern of neural activity in spoken word processing is modulated by the presence of morphological structure, predominantly engaging the left-hemisphere's fronto-temporal language network, and does not require focused attention on the linguistic input.

Background Research on Juvenile Idiopathic Arthritis (JIA) should support patients, caregivers/parents (carers) and clinicians to make important decisions in the consulting room and eventually to improve the lives of patients with JIA. Thus far these end-users of JIA-research have rarely been involved in the prioritisation of future research. Main body Dutch organisations of patients, carers and clinicians will collaboratively develop a research agenda for JIA, following the James Lind Alliance (JLA) methodology. In a ‘Priority Setting Partnership’ (PSP), they will gradually establish a top 10 list of the most important unanswered research questions for JIA. In this process the input from clinicians, patients and their carers will be equally valued. Additionally, focus groups will be organised to involve young people with JIA. The involvement of all contributors will be monitored and evaluated. In this manner, the project will contribute to the growing body of literature on how to involve young people in agenda setting in a meaningful way. Conclusion A JIA research agenda established through the JLA method and thus co-created by patients, carers and clinicians will inform researchers and research funders about the most important research questions for JIA. This will lead to research that really matters.

A rapid review is a form of evidence synthesis considered a resource-efficient alternative to the conventional systematic review. Despite a dramatic rise in the number of rapid reviews commissioned and conducted in response to the coronavirus disease 2019 pandemic, published evidence on the optimal methods of planning, doing, and sharing the results of these reviews is lacking. The Priority III study aimed to identify the top 10 unanswered questions on rapid review methodology to be addressed by future research. A modified James Lind Alliance Priority Setting Partnership approach was adopted. This approach used two online surveys and a virtual prioritization workshop with patients and the public, reviewers, researchers, clinicians, policymakers, and funders to identify and prioritize unanswered questions. Patients and the public, researchers, reviewers, clinicians, policymakers, and funders identified and prioritized the top 10 unanswered research questions about rapid review methodology. Priorities were identified throughout the entire review process, from stakeholder involvement and formulating the question, to the methods of a systematic review that are appropriate to use, through to the dissemination of results. The results of the Priority III study will inform the future research agenda on rapid review methodology. We hope this will enhance the quality of evidence produced by rapid reviews, which will ultimately inform decision-making in the context of healthcare. [Display omitted]

BackgroundThe priorities for UK emergency medicine research were defined in 2017 by a priority setting partnership coordinated by the Royal College of Emergency Medicine in collaboration with the James Lind Alliance (JLA). Much has changed in the last 5 years, not least a global infectious disease pandemic and a significant worsening of the crisis in the urgent and emergency care system. Our aim was to review and refresh the emergency medicine research priorities.MethodsA steering group including patients, carers and healthcare professionals was established to agree to the methodology of the refresh. An independent adviser from the JLA chaired the steering group. The scope was adult patients in the ED. New questions were invited via an open call using multiple communications methods ensuring that patients, carers and healthcare professionals had the opportunity to contribute. Questions underwent minisystematic (BestBETs) review to determine if the question had been answered, and the original 2017 priorities were reviewed. Any questions that remained unanswered were included in an interim prioritisation survey, which was distributed to patients, carers and healthcare professionals. Rankings from this survey were reviewed by the steering group and a shortlist of questions put forward to the final workshop, which was held to discuss and rank the research questions in order of priority.Results77 new questions were submitted, of which 58 underwent mini-systematic review. After this process, 49 questions (of which 32 were new, 11 were related to original priorities and 6 unanswered original priorities were carried forward) were reviewed by the steering group and included in an interim prioritisation survey. The interim prioritisation survey attracted 276 individual responses. 26 questions were shortlisted for discussion at the final prioritisation workshop, where the top 10 research priorities were agreed.ConclusionWe have redefined the priorities for emergency medicine research in the UK using robust and established methodology, which will inform the agenda for the coming years.

Long-standing affective science theories conceive the perception of emotional stimuli either as discrete categories (for example, an angry voice) or continuous dimensional attributes (for example, an intense and negative vocal emotion). Which position provides a better account is still widely debated. Here we contrast the positions to account for acoustics-independent perceptual and cerebral representational geometry of perceived voice emotions. We combined multimodal imaging of the cerebral response to heard vocal stimuli (using functional magnetic resonance imaging and magneto-encephalography) with post-scanning behavioural assessment of voice emotion perception. By using representational similarity analysis, we find that categories prevail in perceptual and early (less than 200 ms) frontotemporal cerebral representational geometries and that dimensions impinge predominantly on a later limbic–temporal network (at 240 ms and after 500 ms). These results reconcile the two opposing views by reframing the perception of emotions as the interplay of cerebral networks with different representational dynamics that emphasize either categories or dimensions. Are vocal emotions perceived as categories (for example, anger) or as dimensions (for example, an intense negative emotion)? Here, using functional magnetic resonance imaging and magneto-encephalography, Giordano et al. find that categories prevail in early (less than 200 ms) neural representations, whereas dimensions emerge later (240 ms and more than 500 ms).

Rapid and automatic processing of grammatical complexity is argued to take place during speech comprehension, engaging a left-lateralised fronto-temporal language network. Here we address how neural activity in these regions is modulated by the grammatical properties of spoken words. We used combined magneto- and electroencephalography (MEG, EEG) to delineate the spatiotemporal patterns of activity that support the recognition of morphologically complex words in English with inflectional (-s) and derivational (-er) affixes (e.g. bakes, baker). The mismatch negativity (MMN), an index of linguistic memory traces elicited in a passive listening paradigm, was used to examine the neural dynamics elicited by morphologically complex words. Results revealed an initial peak 130-180 ms after the deviation point with a major source in left superior temporal cortex. The localisation of this early activation showed a sensitivity to two grammatical properties of the stimuli: 1) the presence of morphological complexity, with affixed words showing increased left-laterality compared to non-affixed words; and 2) the grammatical category, with affixed verbs showing greater left-lateralisation in inferior frontal gyrus compared to affixed nouns (bakes vs. beaks). This automatic brain response was additionally sensitive to semantic coherence (the meaning of the stem vs. the meaning of the whole form) in fronto-temporal regions. These results demonstrate that the spatiotemporal pattern of neural activity in spoken word processing is modulated by the presence of morphological structure, predominantly engaging the left-hemisphere’s fronto-temporal language network, and does not require focused attention on the linguistic input.