Using the nominal group technique to engage stakeholders with experience of stroke in a Cochrane systematic review of physiotherapy treatment approaches

Introduction: It has been recommended that people affected by a healthcare condition are actively involved in systematic reviews; ensuring completed reviews are clinically relevant. We aimed to engage stroke survivors, carers and physiotherapists in a Cochrane systematic review of physiotherapy treatment approaches for patients with stroke.Method: We convened a stakeholder group, comprising 13 purposively selected stroke survivors, carers and physiotherapists. Nominal group techniques were used to reach consensus decisions around review aims and methods, focusing on clinical relevance. The group specifically discussed the categorisation of interventions and inclusion of evidence from a number of international trials, and voted on two key statements: A. “The current categories are appropriate and clinically relevant”; B. “These international trials should be included in our review of physiotherapy treatment approaches”. The proportion agreeing with each statement was determined. Consensus decision meetings wereaudio-recorded and transcribed verbatim. Qualitative data were coded and analysed using NVivo software.Results: 84% of group members disagreed with statement A. 100% agreed with statement B. Two key themes, and several sub-themes, emerged from transcribed data. Key themes were: (1) current intervention categories should be amended to enable inclusion of all international evidence; (2) there are limitations with current physiotherapy taxonomies and concerns surrounding the relevance to clinical practice in the UK. Conclusion: Involving key stakeholders in a Cochrane systematic review of physiotherapy treatment approaches for patients with stroke has influenced decisions around the scope and format of the review, and ensured relevance and accessibility of the output