Table 3 Themes, topics, and research questions with agreement percentages
Topic | Rank | Question | Agreement reached (%) |
|---|---|---|---|
1st: Health economics and service delivery | |||
Service delivery | 1st 54% | Is podiatric surgery efficient and cost effective compared to other providers of foot surgery? | 41 |
Promoting our discipline: what is the understanding of podiatric surgery by other healthcare professionals? How do we raise awareness? | 27 | ||
What is the place of podiatric surgery in mainstream medical care? | 23 | ||
What has been the impact of independent prescribing on podiatric surgery? | 6 | ||
What methods of service promotion are most effective in podiatric surgery? | 3 | ||
Population health | 2nd 41% | How does podiatric surgery benefit the health of the population? | 73** |
What are the demographics of patients accessing podiatric surgery services and do they represent all groups in the local community? | 14 | ||
What is the recurrence rate of hallux valgus following correction via osteotomy? | 13 | ||
Covid-19 | 3rd 5% | What operational changes to podiatric surgery have occurred during the pandemic? | 42 |
What role has podiatric surgery played during the pandemic? | 31 | ||
What is the incidence of post-surgery venous thromboembolism in relation to Covid-19 vaccination in podiatric surgery? | 28 | ||
2nd: Treatment | |||
Surgical treatment: forefoot | 1st 78% | Review of long-term outcomes of implants (e.g., 1st metatarsophalangeal joint, interphlex, proximal interphalangeal joint) | 27 |
Minimally invasive surgery versus open lesser metatarsal surgery – what are the outcomes? | 26 | ||
What are the latest techniques in forefoot surgery? | 20 | ||
Randomised study of hammer toe fusion version arthroplasty | 17 | ||
Deep transverse ligament release vs. neurectomy: A comparative study | 6 | ||
What is the consensus on neuroma surgery: plantar versus dorsal incision, single versus double? | 4 | ||
Post-operative management | 2nd 64% | What post-operative protocols are used following surgery (procedure specific), and do they affect patient reported outcome measures and time to recovery? | 46 |
Review of post-op regimen for procedures – what is the consensus throughout the profession? | 23 | ||
Do post-operative range of motion exercises following hallux valgus correction improve patient outcomes? | 16 | ||
What is the most effective strategy for reducing digital swelling post-operatively? | 8 | ||
What are the best modalities for reducing post-operative scarring? | 6 | ||
Surgical treatment: midfoot | 3rd 62% | What is the most effective Lapidus fixation option? | 62* |
Is the trephine grafting technique superior to traditional joint preparation in midfoot fusion? | 31 | ||
What are the financial implications of different fixation techniques for Lapidus? | 7 | ||
GIRFT | 4th 54% | Are current thoughts regarding common risks of surgery true, or are they outdated and incorrect? | 51 |
What patient safety tools are in use in podiatric surgery, and have they reduced errors? | 29 | ||
Minimising risk: does the imaging report match the request? Is it reducing costs? Are imaging modalities being used appropriately? | 18 | ||
Is the World Health Organisation checklist fit for purpose? | 3 | ||
3rd: Limb Salvage | |||
Surgery / Treatment | 1st 41% | What are the multi-centre outcomes of podiatric surgery in limb salvage of the diabetic foot? | 45 |
Elective prophylactic and curative approaches in limb salvage surgery, how do we compare our data using PASCOM-10 (National database) as a tool? | 29 | ||
Do variations in peri-operative management affect outcomes in the diabetic foot? | 26 | ||
Cost-efficiency | 2nd 26% | What are the short-, medium-, and long-term benefits of our involvement in limb salvage surgery-does it help? Does it save money? What quantifiable data can we publish to develop this arm of the profession? | 50 |
Is our involvement in limb salvage surgery beneficial to patients and financially favourable to Trusts: a long-term study of outcomes and finances | 36 | ||
What models are currently being used in the management of the diabetic foot? Is one more cost-effective than the other and do they affect the patient pathway and outcomes? | 15 | ||
Multi-disciplinary team | 3rd 25% | What is the understanding of podiatric surgery in the wider multi-disciplinary team? | 52 |
Advancements in the diabetic foot – working with vascular in the acute setting | 44 | ||
Do we meet the national criteria? | 4 | ||
Patient experience | 4th 8% | How does podiatric surgery benefit the health of the population in the at-risk foot? | 63* |
What is the psychological impact of diabetic foot ulceration and lower limb amputation | 20 | ||
What is the patient experience of podiatric surgery in the management of their diabetic foot ulcer? | 14 | ||
Did Covid-19 delay patients seeking treatment for diabetic foot ulceration and how has this affected prognosis and outcomes? | 3 | ||
4th: Patient satisfaction and patient-reported outcomes | |||
Patient reported outcome measures | 1st 66% | What is the benefit of utilising PASCOM-10 to improve large scale outcomes data? | 53 |
Is the Manchester Oxford Foot Questionnaire valid in elective foot surgery other than hallux valgus correction? | 23 | ||
How does the patient’s verbal report of surgical success relate to quantitative PROMS? | 14 | ||
Are the Short form-36 and EuroQol-5D valid in elective foot surgery? | 11 | ||
Patient satisfaction | 2nd 34% | How does quality of life improve following elective foot surgery? | 77*** |
What are the patient experiences of day case foot surgery? | 10 | ||
What is the effect of hallux valgus deformity on quality of life? | 8 | ||
Does hallux valgus surgery reduce falls in elderly patients? | 4 | ||