Translation of oral health research priorities into research topics in an equity-based priority setting exercise

Translation of oral health research priorities into research topics in an equity-based priority setting exercise | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Translation of oral health research priorities into research topics in an equity-based priority setting exercise Sumanth Kumbargere Nagraj, Mona Nasser, Cath Quinn, Lynne Callaghan, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4413817/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Jan, 2025 Read the published version in Health Research Policy and Systems → Version 1 posted 8 You are reading this latest preprint version Abstract Background: In the context of research priority setting, participants express their research priorities and ideas in various forms, ranging from narratives to explicit topics or questions. However, the transition from these expressions to well-structured research topics or questions is not always straightforward. Challenges intensify when research priorities pertain to interventions or diagnostic accuracy, requiring the conversion of narratives into the PICO (Participant, Intervention, Comparator, Outcome) format. Scope and findings: This project aimed to understand the challenges of engaging a diverse, multilingual population in setting oral health research priorities. While not a comprehensive priority-setting effort, we modified James Lind Alliance's (JLA) methods and used thematic analysis to establish a list of priority research topics and questions. This was accomplished by conducting interviews with 40 community participants and 14 dentists from various ethnic backgrounds in Malaysia. The interview language depended on participant preferences, including English, Malay, and Mandarin, with translations handled collaboratively by bilingual research assistants. The process involved thematic analysis, discussion with a research committee, and necessary modifications. Our interpretations revealed distinct categories of participant statements: explicit, complicated, implicit, and incomplete. In this study, we identified a three-step approach to translate research ideas that are presented either as explicit statements or as complicated narratives. Conclusions: Translating community research priorities poses inherent challenges. Our model, although not exhaustive, provides a valuable tool to assist research priority-setting groups in translating these priorities into meaningful research topics and questions, facilitating the equitable inclusion of diverse perspectives. Future research priority-setting endeavours should document their translation processes, thus aiding researchers in understanding and tackling the intricacies of this task. Translation research priority setting research topics research questions Figures Figure 1 Introduction Research priority setting is defined as “ any interpersonal activity that leads to the selection of topics and/or choices of key questions to investigate” [ 1 ]. In the process of research priority setting, participants express their research priorities and ideas in various formats such as narratives, topics, or questions. However, it may not always be straightforward statements that are easy to transform into well-defined research topics or questions. Many times, these research ideas are expressed in a complex way and do not make meaningful research questions until the context is understood. In some cases, spoken language and dialects, cultural influences and the mother tongue shape intricate research ideas and these ideas may be difficult to translate and comprehend. When the research priorities revolve around interventions, diagnostic accuracy or prognosis, an additional challenge arises in converting these narratives, topics, or questions into the PICO format. Some of the research ideas are not mature enough to be formatted into a research topic or question and thus need additional input from subject experts. Different research priority setting groups have employed diverse approaches to develop meaningful research topics and questions. For instance, Shah et al. [ 2 ] categorized research priorities according to predefined domains and themes, followed by in-depth discussions involving subject experts during a two-day workshop. In contrast, James Lind Alliance [ 3 ] recommends the establishment of a steering committee tasked with deliberating on research priorities and deriving research topics and questions. This transparent process ensures that the interpretation of research priorities remains fair, impartial, and accurate. In a unique approach called Research Prioritization by Affected Communities (RPAC), an exploratory method was used. In this approach, the participants shared their experiences and collaboratively transformed these experiences into research topics and questions. This entire process was performed as a group activity led by the research team [ 4 ]. Subsequently, the research team refined these research topics and questions. In a similar vein, a community-based participatory approach combined with consensus-building activities was reported. In this approach, participants initially received education on clinical trial designs, effectiveness research, quality improvement, patient-centred research, patient-centred outcomes, and patient registries. They then attended an in-person workshop led by a facilitator, which enabled them to translate their research ideas into research topics and questions. These were later thematically analysed by the research team [ 5 ]. The "World Café" approach is a participatory method for engaging patients and communities in research prioritisation. With this approach, there is no pressure to reach a consensus, and diverse opinions are encouraged. Participants facilitated their own discussions, either individually or in groups, which were recorded. Subsequently, these recordings were reviewed by a large, assembled group to prioritize and were then thematically analysed by the university research team [ 6 ]. However, there is no universally accepted method for translating research priorities into properly structured research topics or questions. Objective The objective of this paper is to describe a comprehensive method for translating research ideas or research priorities into structured research topics or questions. This is part of the larger project (Sumanth Kumbargere Nagraj's (SKN) PhD research) which aimed to comprehend the challenges associated with involving a multiethnic population that speaks different languages in an oral health research priority setting exercise and to share the learning points with other researchers. Methods As part of the larger project, the research team conducted interviews with 40 community participants and 14 dentists from four different ethnic groups in Malaysia. These participants were tasked with prioritizing three distinct research topics related to oral health, and the interviews were recorded and translated. The interviews were conducted in English, Malay, or Mandarin, depending on the participants' preferences. The Malay and Mandarin interviews were translated by two bilingual research assistants, and a final transcript was generated through collaborative discussions to resolve any differences. To maintain anonymity, the names of the participants were pseudonymized, ensuring that they matched their gender and ethnicity. This project was not a comprehensive research priority-setting activity that ideally consists of planning, implementing, publishing and evaluating phases [7] and was limited only to the planning and a part of the implementing phase. We did not fully adhere to the methods outlined in the literature for translating research ideas into research topics and questions. Nevertheless, we adapted the methods suggested by the JLA [3] and employed thematic analysis [8] to finalize the list of priority research topics and questions, as described in the following section. To derive a list of priority research topics and questions from these transcripts, we opted for a stepwise approach, as outlined below: Thematic Analysis: A single researcher conducted a thematic analysis of the interview recordings and transcripts and interpreted the research topics/questions. Discussion with a research committee: The results were presented and discussed within a research committee. The purpose of this discussion was to ensure a proper understanding and interpretation of the research ideas. Modifications: Based on the discussion, themes and research topics/questions were modified. We also established the following guiding principles for the translation: The translated research topic/question should reflect the original statement given by the stakeholders. The values and preferences of the stakeholders should be considered. The research topic/question should match with the prioritisation reason as mentioned by the stakeholders. Thematic Analysis In both the interviews with dentists and the interviews with community participants, the conversations were analysed to understand the specific research topics or research questions intended by the participants. In some instances, the research topics/questions were readily apparent, as the participants had clearly articulated them. If the research topics/questions were evident during the interview, the interviewer confirmed their understanding with the participant, who could then clarify further. However, in some cases, understanding the research question was not straightforward. In these instances, SKN carefully reviewed the recordings, transcripts, and reflexivity statements to interpret the most likely research topic/question that the participant was indicating. Drawing from our experience in interpreting priority research topics/questions, we classified the participant statements into two types: a. Explicit Statements: The majority of participants from both the dentist and community participant groups provided explicit statements during the interviews. For example, a community participant reported that government clinic dentists and their assistants should be trained to be more customer friendly. This statement was easily interpreted as the research topic, "government healthcare workers should be more respectful." Similarly, a participant suggested that research should address immediate issues such as broken dentures in government clinics. This was interpreted as "reduce the waiting period in government clinics" rather than "reduce the waiting period for emergency dental treatment in government clinics," as broken dentures are not considered dental emergencies, and Malaysian government hospitals promptly attend to predefined dental emergencies. Some participants prepared more than the required three research topics/questions. For example, an elderly participant listed seven research topics. This suggests that some participants may have mentioned additional topics if not limited by the Participant Information Sheet. b. Complicated Statements: Three types of complicated statements were observed among participants: i. Confused Statements: Some participants provided vague answers, explaining multiple research topics/questions and shifting between them, making it challenging to interpret their intended research priorities. They might start by justifying their prioritization and then provide minimal details on the topic/question. For example, a participant prioritised reducing the time taken for wisdom tooth removal because her dentist struggled during the procedure, causing inconvenience. Following this portion of the interview, when the interviewer inquired about potential enhancements to dental procedures, the participant connected this question to the topic of wisdom tooth removal and expressed her trust in the dentist she had known since she was young. During the interviews, we were unable to establish a direct connection between the participant's faith in her family dentist and her experience with wisdom tooth removal. Therefore, it was later interpreted that the participant had confidence in her dentist's skills, leading to the research topic of "techniques to reduce the time taken for wisdom tooth removal." In another instance, when asked about her research priority, a participant’s statement appeared to lack a specific research topic or question. “Usually before deciding, we would seek recommendations from friends and family for reliable dental clinics. Competent doctors with affordable prices plus facilities in the clinic and good management.” However, upon examining the underlying reason for her prioritization, we were able to discern the intended research topic. The rationale she provided was as follows: "One of my friends got her tooth filled, but after a week, she still had lingering pain and immediately went back to the doctor. He explained that there is still some infection present with pus coming out from the gums." Considering her friend's painful experience, we interpreted this as one of the research topics: 'Improving the clinical skills of dentists.' ii. Implicit Statements: Some participants provided indirect statements, requiring interpretation based on the overall context and reflexivity statements of interviewers and translators. For instance, a participant did not explicitly mention a research priority topic/question but stated: “But there was one case many, many years ago whereby I told the doctor I need to save my teeth because if I don't have this teeth I can’t chew my my food because sometimes we Chinese love to eat the meat uh meat especially pork and chicken Uh, you know, they're very tough so we we need strong teeth to chew my the food.”. Two members of our research team who were dentists are aware that procedures such as root canal treatment and crowning could be employed to salvage a badly decayed tooth. Consequently, drawing from their interpretation and the narrative throughout the entire interview, we inferred the following research question: "How can techniques for preserving badly decayed teeth be enhanced?" rather than simply "Saving badly decayed teeth." Another participant highlighted her priority research topic as focusing on implants for the elderly population with osteoporosis. We understood this as the need to "enhance bone quality to support dental implants." These implicit statements were not limited to the research priority topics and questions but also extended to the reasons behind prioritizing these topics and questions. For instance, participants placed a high priority on promoting oral health care as a topic, even though she did not explicitly state her reason. She conveyed, "Yes, we still need to stimulate people to come for dental check-ups, maybe do a carnival or work in partnership with NGOs". We inferred the reason behind her prioritization as "encouraging more individuals to seek dental check-ups," as she emphasized the need to "stimulate people." Similarly, during another interview, an elderly participant made the following statement: "For the denture, there's one problem for my denture was that I have to return and visit the dentist for amending my denture a few times until it fits comfortably in my mouth". Although this statement did not directly explain her prioritisation, we interpreted it as reflecting the "quality of the dental treatment experience" since she mentioned the word "comfortably." One of the dentists we interviewed articulated all the reasons for prioritization to enhance oral health awareness but provided a vague description of the priority topic, saying: "Aa, something, aa, I mean in, in our system is not working well (giggle) when it comes to oral health". Based on the context within which he discussed the reasons for prioritization, we interpreted this statement as implying the research priority topic. iii. Incomplete Statements: A few participants responded with incomplete or ambiguous answers, sometimes with a simple "yes" or "no." In such cases, translators probed for more information and provided examples, but the participants still did not speak fluently. Research topics/questions had to be interpreted based on these incomplete statements and their responses to the examples given by the translators. For example, one participant mentioned experiencing pain even after dental treatment and suggested that it could be due to incorrect treatment. Further probing by the translator led to a somewhat confused agreement that the pain might be related to a persistent problem in the tooth. The research topic/question had to be interpreted based on these probes. In some cross-language interviews, either the reason for prioritization was not asked by the interviewer, or the participant did not answer appropriately. When the reason could not be determined from the available information, the reason for prioritization was left blank. For instance, one participant suggested promoting oral health care but did not explain the reason. Based on the statement, the research topic was interpreted as "promote oral healthcare." However, in this case, the translator did not inquire about the reason for prioritizing this research topic. Consequently, we refrained from inferring any specific reason for this prioritization due to the lack of information. These complexities in participant responses and their interpretations underscore the nuanced and intricate nature of research topic derivation from the interviews. 2. Discussion with the research committee To validate the interpretations, a research committee comprising five PhD supervisors of SKN was convened. This committee included one subject expert, MN, who was a dental surgeon and a Priority Setting methods expert, as well as one senior academic physician and three experienced qualitative researchers, MP, LC, and CQ. The committee reviewed each research topic along with the related quotes, seeking justifications from the researcher, SKN, who had conducted the thematic analysis. When necessary, the committee offered comments to modify or alter the research topics based on mutual consensus. During these discussions, SKN documented the suggestions and modifications in the meeting minutes, which were later utilized for making the necessary changes. 3. Modifications Following the feedback received during the research committee discussion, we either adjusted the research topics/questions or retained the original interpretations. For transparency, when modifications were made, we documented the reasons for modification alongside both the original and modified research topics/questions (Table 1; Table 2 and Table 3). The modifications of the research topics /questions are illustrated in the Table 1. Table 1 : illustrates an example of the modifications of the research topics/questions which was more specific. Quote Research topic/ question Modified research topic/question Reason “Some of them there's when they want to pull out the teeth they don't feel much pain. Some of the doctors where they go to private… sorry aaa.. Doctors, they just simply never ask whether there still pain or not when they they're going to pull. Of course they should ask the patient whether still pain or not by shaking the teeth and so on. And this know some of them know they just go, they just pull.” How to improve empathy in dentists? How to ensure that the dentist-patient interaction provides enough opportunities for patients to express and communicate their pain experience and their needs? How do train dentists to recognise when the patient is in pain and respond and react to it and empower the patient to communicate? The modified research questions are more specific and reflect the research idea stated by the participant. There were instances where the participants shared research ideas based on their assumptions or misconceptions. In such cases we had to precautiously rephrase the research questions to reflect the nearest meaning of the statement. Two such examples are shared in Table 2. Table 2 : illustrates examples of the modifications of the research topics/questions to reflect the nearest meaning of the statement. Quote First interpretation of research topic/question Modified research topic/question Reason “If you can come up the with something, you know how to scrape off the nicotine before it destroy the original teeth.” How can the effects of nicotine be reduced on teeth? How smoking can affect oral health? The patient seems to assume that the deposition of nicotine itself is a reason for their oral health issues which is not correct. However, smoking can affect it so we changed the question focusing on smoking and oral health rather than nicotine disposition which is a mechanism that does not connect these to “…those days the doctors which I have gone to they are more professional and then nowadays sorry to say that the student their they don't understand English that well. And I gone through one experience in xxx Polyclinic I go for my check up and I attend for my Aerobic classes. This two European lady who just arrived Malaysia and she wants to go for a check-up. When she talk to the nurses they don’t understand no response to him and the wife. The wife was surprised!” How to improve English language communication of dental healthcare providers with patients? How to provide support for local dentists to communicate and engage with groups who have a different language? What are the other characteristics a dentist needs to have to be accepted in that community e.g. some expressed that a dentist should be able to understand dentist to be considered a respected educated professional? The participant is an elderly lady whose grandfather was working for British during the colonial rule and assumes that a medical healthcare professional should know English and otherwise they are not fit to pursue their job effectively. Such behaviour is not uncommon in Malaysia which was once a British colony and the script of the national language, Bahasa Malaysia is English. Some of the research ideas were not feasible due to existing regulatory issues. In such cases, we have modified the research questions to reflect the nearest research idea. An example for this is illustrated in Table 3. Table 3 : illustrates an example of the modifications of the research topics/questions to reflect the nearest research idea. Quote First interpretation of research topic/question Modified research topic/question Reason Participant: “Doctor, I would like to ask you. Those days when I was at school, it is imagine I'm 66. So when I was in the primary school, which is below 12 years old, the school did the filling for me the black filling, it is so lasting until now. But the recent filling are not as strong as the olden days, so I also wonder why.” I: “So you want those black fillings to be ((Yeah)), re-established?” P: “Yes”. Can we re-establish dental amalgam as a choice of restorative material? How to eliminate the dental amalgam related mercury toxicity in the environment? How to increase the durability and longevity of newer filling materials? Based on the Minamata convention on Mercury 2014 report [9], dental amalgam needs to be phased out by year 2030. Therefore, the research questions were modified. Proposed model Based on our experience, we propose the following model (Figure 1) for translating participant opinions, views, research ideas or research priorities to research topics/questions. The model is summarised as follows: If research ideas – research priorities are expressed as explicit statements – can be translated to research topics – questions without much difficulty. If the statements are confusing, then we need to critically analyse the entire narrative and consider the pre- and post-interview discussions to determine the most likely research topic. If the statements are implicit, we should take the help of subject experts to interpret or verify the interpretation, consider the reason or justification for the research idea, and, if necessary, validate with a research committee and mark the final research topic/question as `implied´. If the statements are incomplete, researchers should determine the cause of the incomplete statements. If the reason is hesitation or fear, this can be verified in the reflexivity statements of the interviewer that aid in the completion of the research idea and thus determine the research topic-question. If the interviewer used any probes to obtain the complete statement, those probes were used for the better interpretation. If there are no other clues to complete the statements, leave such research ideas as empty and mark them. Discussion In the Cochrane collaboration, JLA and NIHR PenARC (Peninsula Applied Research Collaboration) collected research topics/ questions in PICO format. However, not all stakeholders can comprehend their research ideas in such a format. It is indeed a challenging task to translate research priorities or research ideas from community participants into proper research questions that fit the PICO format [3], as the process involves interpretation and subjectivity. This process is not a simple linguistic translation but rather a translation of cultural issues. Furthermore, there is a paucity of literature providing guidance on the translation of research priorities. Our translation model can serve as a simple tool to assist research priority-setting groups in interpreting the research priorities or ideas put forth by community participants. Our translation model is different from the guiding principles of topic refinement reported by Buckley et al [10]. The guiding principles of topic refinement were proposed for systematic reviews and consider the feasibility and relevance of the proposed research topics/ questions. However, we did not judge the proposed research ideas or priorities based on feasibility or relevance aspects in accordance with our three guiding principles. In a Cochrane Oral Health Research Priority-Setting exercise [11], refinement of the research topics/questions was performed by a stakeholder committee with 30 members in the initial phase and was further refined by content experts in the implementation phase. However, the details of how the topics/questions were refined are not discussed. The priority research topics suggested by the participants may or may not address existing research gaps. Some research topics/questions may already be established or answered, and the participants may not be aware of this (referred to as an information gap or implementation gap). This research project's scope does not involve listing topics/questions that pertain to research gaps. Therefore, regardless of the type of suggestions made by the participants, we translated them into research topics/questions. Throughout this process of interpreting and comprehending research topics/questions, the interview process played a significant role. As a natural part of the interviews, the interviewer-initiated conversations with greetings, self-introductions, explanations of the research project's purpose, and responses to any last-minute queries. Some participants provided examples of research topics/questions and inquired if they would fit the project. Others shared their dental problems, seeking consultation or guidance. A few participants were familiar to the interviewers as previous patients or acquaintances who had discussed dental issues in the past. These participants assumed that the interviewer would remember their dental concerns and based their statements on these assumptions. In some cases, these participants may have expressed themselves partially or given implicit statements, presuming that the interviewer would link them to previous dental treatment sessions and discussions. In such instances, relying solely on the interview transcripts for interpretation would not have been sufficient. Since these prior discussions were not recorded, the interviewers documented points in reflexivity statements whenever they believed these discussions would aid in a better interpretation of the interviews. These reflexivity notes proved valuable in deciphering some of the complex statements and establishing connections to the priority topics and reasons for prioritization. Conclusion Future research priority setting activities should include detailed accounts of how they translated research priorities/ideas into research questions/topics, complete with examples and the challenges faced during this process. Such information will serve as a valuable guide for researchers in translating intricate narratives into meaningful research topics/questions. Although our guidance model may not encompass all potential issues that a research priority setting group could encounter, it can be a useful tool for streamlining the process of translating research priorities or ideas. Declarations Human Ethics and Consent to Participate declarations This study was approved in accordance with the Declarations of Helsinki by the Research and Ethics Committee of Melaka-Manipal Medical College, Melaka, Malaysia (Ref no. MMMC/FOM/Research Ethics Committee-2/2019 dated 15 September 2019) and the Ethics Committee of the University of Plymouth, Plymouth, United Kingdom (Ref no. 19/20 – 1199 dated 11 March 2020 and 28 April 2020). Informed consent was obtained from all the participants and translators. Consent for publication We have obtained consent from the participants and translators to share the anonymised data in publications, presentations and other scholarship activities. Availability of data and materials The complete list of research priorities and research topics/questions are available in the OSF data repository: https://osf.io/89ptj/?view_only=3577d32515d54ae789a7016dbe345df4 Competing interests Sumanth Kumbargere Nagraj: None Mona Nasser: None Rupert Jones: None Lynne Callaghan: None Cath Quinn: None Martha Paisi: None Funding This manuscript is part of the PhD work of Sumanth Kumbargere Nagraj and has not received any funding. Author contributions Sumanth Kumbargere Nagraj: conceptualisation, data collection, analysis and drafting of the manuscript Mona Nasser: conceptualisation, modifications of research topics/questions, proof reading and supervision of work Rupert Jones: modifications of research topics/questions, proofreading and supervision of work Lynne Callaghan: modifications of research topics/questions, proofreading and supervision of work Cath Quinn: modifications of research topics/questions, proofreading and supervision of work Martha Paisi: modifications of research topics/questions, proofreading and supervision of work Acknowledgements The authors thank the translators, Prof.Dr.Noorliza Mastura Ismail, Ms.Zainah Ibrahim, Dr.Hoe Fong, Dr.Tan Silk, Dr.Ming Yin, Dr.Bryan John Paulose and Mrs.Shanti Murugan who translated the interviews in the Bahasa Melayu and Mandarin languages and Dr.Lynn Varghese for helping in transcriptions. Author information Not applicable References Nasser M. Setting priorities for conducting and updating systematic reviews [dissertation on the internet]. University of Plymouth; 2018 [cited 2024 23 Feb 24]. Available from: https://pearl.plymouth.ac.uk/handle/10026.1/10849 Shah H, Albanese E, Duggan C, Rudan I, Langa KM, Carrillo MC, et al. Research priorities to reduce the global burden of dementia by 2025. Lancet Neurol. 2016;15:1285-94. doi: 10.1016/S1474-4422(16)30235-6. James Lind Alliance. Setting up a priority setting partnership. In: James Lind Alliance Guidebook. 2021. https://www.jla.nihr.ac.uk/jla-guidebook/downloads/JLA-Guidebook-Version-10-March-2021.pdf. Accessed 15 Feb 2024. Franck LS, McLemore MR, Cooper N, De Castro B, Gordon AY, Williams S, et al. A novel method for involving women of colour at high risk for preterm birth in research priority setting. J Vis Exp [Internet]. 2018;12:131. Gross PH, Bailes AF, Horn SD, Hurvitz EA, Kean J, Shusterman M; et al. Setting a patient-centered research agenda for cerebral palsy: a participatory action research initiative. Dev Med Child Neurol. 2018 Dec;60:1278-84. doi: 10.1111/dmcn.13984. MacFarlane A, Galvin R, O'Sullivan M, McInerney C, Meagher E, Burke D, et al. Participatory methods for research prioritization in primary care: an analysis of the World Café approach in Ireland and the USA. Fam Pract. 2017;34:278-84. doi: 10.1093/fampra/cmw104. World Health Organisation. A systematic approach for undertaking a research priority-setting exercise. Guidance for WHO staff. 2020. https://iris.who.int/bitstream/handle/10665/334408/9789240009622-eng.pdf?sequence=1. Accessed 21 Jan 2024. Braun V., Clarke V. Thematic analysis: A practical guide. London: Sage; 2022. Bailey, Marianne (24 February 2014). "Minamata Convention on Mercury". United States Environmental Protection Agency. Archived from the original on 19 October 2014. Accessed on 31 October 2023. Buckley DI, Ansari MT, Butler M, Soh C, Chang CS. The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program. J Clin Epidemiol. 2014;67:425-32. doi: 10.1016/j.jclinepi.2013.10.023. Anne Littlewood. Developing a framework for priority-setting in evidence synthesis: a case study of Cochrane Oral Health [dissertation on the internet]. Manchester: University of Manchester; 2022 [cited on 17 November 2023]. Available from: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.873918 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 21 Jan, 2025 Read the published version in Health Research Policy and Systems → Version 1 posted Editorial decision: Revision requested 10 Nov, 2024 Reviews received at journal 13 Jun, 2024 Reviewers agreed at journal 23 May, 2024 Reviewers agreed at journal 22 May, 2024 Reviewers invited by journal 22 May, 2024 Submission checks completed at journal 22 May, 2024 Editor assigned by journal 22 May, 2024 First submitted to journal 13 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4413817","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309682819,"identity":"7545cca2-8476-480d-bc77-2f6aaf315b23","order_by":0,"name":"Sumanth Kumbargere Nagraj","email":"data:image/png;base64,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","orcid":"","institution":"Clinical Lecturer, University of Plymouth","correspondingAuthor":true,"prefix":"","firstName":"Sumanth","middleName":"Kumbargere","lastName":"Nagraj","suffix":""},{"id":309682822,"identity":"8afd8328-f36f-4df9-90b9-62d259b8c8c3","order_by":1,"name":"Mona Nasser","email":"","orcid":"","institution":"University of Plymouth","correspondingAuthor":false,"prefix":"","firstName":"Mona","middleName":"","lastName":"Nasser","suffix":""},{"id":309682823,"identity":"e00889ab-e5b0-4b1e-8a66-88cafead3fab","order_by":2,"name":"Cath Quinn","email":"","orcid":"","institution":"University of Plymouth","correspondingAuthor":false,"prefix":"","firstName":"Cath","middleName":"","lastName":"Quinn","suffix":""},{"id":309682826,"identity":"a63d8f68-f86f-413c-80e1-00887a1abd27","order_by":3,"name":"Lynne Callaghan","email":"","orcid":"","institution":"University of Plymouth","correspondingAuthor":false,"prefix":"","firstName":"Lynne","middleName":"","lastName":"Callaghan","suffix":""},{"id":309682828,"identity":"7b205d81-2f34-4f48-a409-142833a2f0c7","order_by":4,"name":"Martha Paisi","email":"","orcid":"","institution":"University of Plymouth","correspondingAuthor":false,"prefix":"","firstName":"Martha","middleName":"","lastName":"Paisi","suffix":""}],"badges":[],"createdAt":"2024-05-13 14:18:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4413817/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4413817/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12961-024-01261-0","type":"published","date":"2025-01-21T15:56:57+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":58067769,"identity":"8b7dc1f4-560d-43e7-91f9-22ecc68024d4","added_by":"auto","created_at":"2024-06-10 18:03:03","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":443399,"visible":true,"origin":"","legend":"\u003cp\u003eillustrating the 3-step process for translating participant opinions, views, research ideas or research priorities to research topics/questions\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4413817/v1/8a42cd531a5be99807ac2b25.jpeg"},{"id":74858489,"identity":"e8a19eae-0098-4cd4-93fc-51e150542586","added_by":"auto","created_at":"2025-01-27 16:10:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":973337,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4413817/v1/99369cff-c967-4f31-9e59-7457f2578b4f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Translation of oral health research priorities into research topics in an equity-based priority setting exercise","fulltext":[{"header":"Introduction","content":"\u003cp\u003eResearch priority setting is defined as \u0026ldquo;\u003cem\u003eany interpersonal activity that leads to the selection of topics and/or choices of key questions to investigate\u0026rdquo;\u003c/em\u003e [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In the process of research priority setting, participants express their research priorities and ideas in various formats such as narratives, topics, or questions. However, it may not always be straightforward statements that are easy to transform into well-defined research topics or questions. Many times, these research ideas are expressed in a complex way and do not make meaningful research questions until the context is understood. In some cases, spoken language and dialects, cultural influences and the mother tongue shape intricate research ideas and these ideas may be difficult to translate and comprehend. When the research priorities revolve around interventions, diagnostic accuracy or prognosis, an additional challenge arises in converting these narratives, topics, or questions into the PICO format. Some of the research ideas are not mature enough to be formatted into a research topic or question and thus need additional input from subject experts.\u003c/p\u003e \u003cp\u003eDifferent research priority setting groups have employed diverse approaches to develop meaningful research topics and questions. For instance, Shah et al. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] categorized research priorities according to predefined domains and themes, followed by in-depth discussions involving subject experts during a two-day workshop. In contrast, James Lind Alliance [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] recommends the establishment of a steering committee tasked with deliberating on research priorities and deriving research topics and questions. This transparent process ensures that the interpretation of research priorities remains fair, impartial, and accurate. In a unique approach called Research Prioritization by Affected Communities (RPAC), an exploratory method was used. In this approach, the participants shared their experiences and collaboratively transformed these experiences into research topics and questions. This entire process was performed as a group activity led by the research team [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Subsequently, the research team refined these research topics and questions. In a similar vein, a community-based participatory approach combined with consensus-building activities was reported. In this approach, participants initially received education on clinical trial designs, effectiveness research, quality improvement, patient-centred research, patient-centred outcomes, and patient registries. They then attended an in-person workshop led by a facilitator, which enabled them to translate their research ideas into research topics and questions. These were later thematically analysed by the research team [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The \"World Caf\u0026eacute;\" approach is a participatory method for engaging patients and communities in research prioritisation. With this approach, there is no pressure to reach a consensus, and diverse opinions are encouraged. Participants facilitated their own discussions, either individually or in groups, which were recorded. Subsequently, these recordings were reviewed by a large, assembled group to prioritize and were then thematically analysed by the university research team [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, there is no universally accepted method for translating research priorities into properly structured research topics or questions.\u003c/p\u003e \u003cp\u003eObjective\u003c/p\u003e \u003cp\u003eThe objective of this paper is to describe a comprehensive method for translating research ideas or research priorities into structured research topics or questions.\u003c/p\u003e \u003cp\u003e This is part of the larger project (Sumanth Kumbargere Nagraj's (SKN) PhD research) which aimed to comprehend the challenges associated with involving a multiethnic population that speaks different languages in an oral health research priority setting exercise and to share the learning points with other researchers.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eAs part of the larger project, the research team conducted interviews with 40 community participants and 14 dentists from four different ethnic groups in Malaysia. These participants were tasked with prioritizing three distinct research topics related to oral health, and the interviews were recorded and translated. The interviews were conducted in English, Malay, or Mandarin, depending on the participants' preferences. The Malay and Mandarin interviews were translated by two bilingual research assistants, and a final transcript was generated through collaborative discussions to resolve any differences. To maintain anonymity, the names of the participants were pseudonymized, ensuring that they matched their gender and ethnicity.\u003c/p\u003e\n\u003cp\u003eThis project was not a comprehensive research priority-setting activity that ideally consists of planning, implementing, publishing and evaluating phases [7] and was limited only to the planning and a part of the implementing phase.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe did not fully adhere to the methods outlined in the literature for translating research ideas into research topics and questions. Nevertheless, we adapted the methods suggested by the JLA [3] and employed thematic analysis [8] to finalize the list of priority research topics and questions, as described in the following section.\u003c/p\u003e\n\u003cp\u003eTo derive a list of priority research topics and questions from these transcripts, we opted for a stepwise approach, as outlined below:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eThematic Analysis: A single researcher conducted a thematic analysis of the interview recordings and transcripts and interpreted the research topics/questions.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDiscussion with a research committee: The results were presented and discussed within a research committee. The purpose of this discussion was to ensure a proper understanding and interpretation of the research ideas.\u003c/li\u003e\n \u003cli\u003eModifications: Based on the discussion, themes and research topics/questions were modified.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eWe also established the following guiding principles for the translation:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eThe translated research topic/question should reflect the original statement given by the stakeholders.\u003c/li\u003e\n \u003cli\u003eThe values and preferences of the stakeholders should be considered.\u003c/li\u003e\n \u003cli\u003eThe research topic/question should match with the prioritisation reason as mentioned by the stakeholders.\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch3\u003eThematic Analysis\u003c/h3\u003e\n\u003cp\u003eIn both the interviews with dentists and the interviews with community participants, the conversations were analysed to understand the specific research topics or research questions intended by the participants. In some instances, the research topics/questions were readily apparent, as the participants had clearly articulated them. If the research topics/questions were evident during the interview, the interviewer confirmed their understanding with the participant, who could then clarify further.\u003c/p\u003e\n\u003cp\u003eHowever, in some cases, understanding the research question was not straightforward. In these instances, SKN carefully reviewed the recordings, transcripts, and reflexivity statements to interpret the most likely research topic/question that the participant was indicating.\u003c/p\u003e\n\u003cp\u003eDrawing from our experience in interpreting priority research topics/questions, we classified the participant statements into two types:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea. Explicit Statements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe majority of participants from both the dentist and community participant groups provided explicit statements during the interviews. For example, a community participant reported that government clinic dentists and their assistants should be trained to be more customer friendly.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis statement was easily interpreted as the research topic, \"government healthcare workers should be more respectful.\"\u003c/p\u003e\n\u003cp\u003eSimilarly, a participant suggested that research should address immediate issues such as broken dentures in government clinics. This was interpreted as \"reduce the waiting period in government clinics\" rather than \"reduce the waiting period for emergency dental treatment in government clinics,\" as broken dentures are not considered dental emergencies, and Malaysian government hospitals promptly attend to predefined dental emergencies.\u003c/p\u003e\n\u003cp\u003eSome participants prepared more than the required three research topics/questions. For example, an elderly participant listed seven research topics. This suggests that some participants may have mentioned additional topics if not limited by the Participant Information Sheet.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb. Complicated Statements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThree types of complicated statements were observed among participants:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cu\u003ei. Confused Statements:\u003c/u\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSome participants provided vague answers, explaining multiple research topics/questions and shifting between them, making it challenging to interpret their intended research priorities. They might start by justifying their prioritization and then provide minimal details on the topic/question.\u003c/p\u003e\n\u003cp\u003eFor example, a participant prioritised reducing the time taken for wisdom tooth removal because her dentist struggled during the procedure, causing inconvenience. Following this portion of the interview, when the interviewer inquired about potential enhancements to dental procedures, the participant connected this question to the topic of wisdom tooth removal and expressed her trust in the dentist she had known since she was young.\u003c/p\u003e\n\u003cp\u003eDuring the interviews, we were unable to establish a direct connection between the participant's faith in her family dentist and her experience with wisdom tooth removal. Therefore, it was later interpreted that the participant had confidence in her dentist's skills, leading to the research topic of \"techniques to reduce the time taken for wisdom tooth removal.\"\u003c/p\u003e\n\u003cp\u003eIn another instance, when asked about her research priority, a participant’s statement appeared to lack a specific research topic or question.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e“Usually before deciding, we would seek recommendations from friends and family for reliable dental clinics. Competent doctors with affordable prices plus facilities in the clinic and good management.”\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eHowever, upon examining the underlying reason for her prioritization, we were able to discern the intended research topic. The rationale she provided was as follows:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"One of my friends got her tooth filled, but after a week, she still had lingering pain and immediately went back to the doctor. He explained that there is still some infection present with pus coming out from the gums.\"\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eConsidering her friend's painful experience, we interpreted this as one of the research topics: 'Improving the clinical skills of dentists.'\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cu\u003eii. Implicit Statements:\u003c/u\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSome participants provided indirect statements, requiring interpretation based on the overall context and reflexivity statements of interviewers and translators. For instance, a participant did not explicitly mention a research priority topic/question but stated:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e“But there was one case many, many years ago whereby I told the doctor I need to save my teeth because if I don't have this teeth I can’t chew my my food because sometimes we Chinese love to eat the meat uh meat especially pork and chicken \u0026nbsp;Uh, you know, they're very tough so we we need strong teeth to chew my \u0026nbsp;the food.”.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTwo members of our research team who were dentists are aware that procedures such as root canal treatment and crowning could be employed to salvage a badly decayed tooth. Consequently, drawing from their interpretation and the narrative throughout the entire interview, we inferred the following research question: \"How can techniques for preserving badly decayed teeth be enhanced?\" rather than simply \"Saving badly decayed teeth.\"\u003c/p\u003e\n\u003cp\u003eAnother participant highlighted her priority research topic as focusing on implants for the elderly population with osteoporosis. We understood this as the need to \"enhance bone quality to support dental implants.\"\u003c/p\u003e\n\u003cp\u003eThese implicit statements were not limited to the research priority topics and questions but also extended to the reasons behind prioritizing these topics and questions.\u003c/p\u003e\n\u003cp\u003eFor instance, participants placed a high priority on promoting oral health care as a topic, even though she did not explicitly state her reason. She conveyed,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"Yes, we still need to stimulate people to come for dental check-ups, maybe do a carnival or work in partnership with NGOs\".\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe inferred the reason behind her prioritization as \"encouraging more individuals to seek dental check-ups,\" as she emphasized the need to \"stimulate people.\"\u003c/p\u003e\n\u003cp\u003eSimilarly, during another interview, an elderly participant made the following statement:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"For the denture, there's one problem for my denture was that I have to return and visit the dentist for amending my denture a few times until it fits comfortably in my mouth\".\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAlthough this statement did not directly explain her prioritisation, we interpreted it as reflecting the \"quality of the dental treatment experience\" since she mentioned the word \"comfortably.\"\u003c/p\u003e\n\u003cp\u003eOne of the dentists we interviewed articulated all the reasons for prioritization to enhance oral health awareness but provided a vague description of the priority topic, saying:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"Aa, something, aa, I mean in, in our system is not working well (giggle) when it comes to oral health\".\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBased on the context within which he discussed the reasons for prioritization, we interpreted this statement as implying the research priority topic.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cu\u003eiii. Incomplete Statements:\u003c/u\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA few participants responded with incomplete or ambiguous answers, sometimes with a simple \"yes\" or \"no.\" In such cases, translators probed for more information and provided examples, but the participants still did not speak fluently. Research topics/questions had to be interpreted based on these incomplete statements and their responses to the examples given by the translators.\u003c/p\u003e\n\u003cp\u003eFor example, one participant mentioned experiencing pain even after dental treatment and suggested that it could be due to incorrect treatment. Further probing by the translator led to a somewhat confused agreement that the pain might be related to a persistent problem in the tooth. The research topic/question had to be interpreted based on these probes.\u003c/p\u003e\n\u003cp\u003eIn some cross-language interviews, either the reason for prioritization was not asked by the interviewer, or the participant did not answer appropriately. When the reason could not be determined from the available information, the reason for prioritization was left blank.\u003c/p\u003e\n\u003cp\u003eFor instance, one participant suggested promoting oral health care but did not explain the reason. Based on the statement, the research topic was interpreted as \"promote oral healthcare.\" However, in this case, the translator did not inquire about the reason for prioritizing this research topic. Consequently, we refrained from inferring any specific reason for this prioritization due to the lack of information.\u003c/p\u003e\n\u003cp\u003eThese complexities in participant responses and their interpretations underscore the nuanced and intricate nature of research topic derivation from the interviews.\u003c/p\u003e\n\u003ch3\u003e2. Discussion with the research committee\u003c/h3\u003e\n\u003cp\u003eTo validate the interpretations, a research committee comprising five PhD supervisors of SKN was convened. This committee included one subject expert, MN, who was a dental surgeon and a Priority Setting methods expert, as well as one senior academic physician and three experienced qualitative researchers, MP, LC, and CQ.\u003c/p\u003e\n\u003cp\u003eThe committee reviewed each research topic along with the related quotes, seeking justifications from the researcher, SKN, who had conducted the thematic analysis. When necessary, the committee offered comments to modify or alter the research topics based on mutual consensus. During these discussions, SKN documented the suggestions and modifications in the meeting minutes, which were later utilized for making the necessary changes.\u003c/p\u003e\n\u003ch3\u003e3. Modifications\u003c/h3\u003e\n\u003cp\u003eFollowing the feedback received during the research committee discussion, we either adjusted the research topics/questions or retained the original interpretations. For transparency, when modifications were made, we documented the reasons for modification alongside both the original and modified research topics/questions (Table 1; Table 2 and Table 3).\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eThe modifications of the research topics /questions are illustrated in the Table 1.\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e: illustrates an example of\u0026nbsp;the modifications of the research topics/questions which was more specific.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"948\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.48945147679325%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuote\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.084388185654008%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResearch topic/ question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.329113924050635%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModified research topic/question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.09704641350211%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.48945147679325%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e“Some of them there's when they want to pull out the teeth they don't feel much pain. Some of the doctors where they go to private… sorry aaa.. Doctors, they just simply never ask whether there still pain or not when they they're going to pull. Of course they should ask the patient whether still pain or not by shaking the teeth and so on. And this know some of them know they just go, they just pull.”\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.084388185654008%\" valign=\"top\"\u003e\n \u003cp\u003eHow to improve empathy in dentists?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.329113924050635%\" valign=\"top\"\u003e\n \u003cp\u003eHow to ensure that the dentist-patient interaction provides enough opportunities for patients to express and communicate their pain experience and their needs?\u003c/p\u003e\n \u003cp\u003eHow do train dentists to recognise when the patient is in pain and respond and react to it and empower the patient to communicate?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.09704641350211%\" valign=\"top\"\u003e\n \u003cp\u003eThe modified research questions are more specific and reflect the research idea stated by the participant.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThere were instances where the participants shared research ideas based on their assumptions or misconceptions. In such cases we had to precautiously rephrase the research questions to reflect the nearest meaning of the statement. Two such examples are shared in Table 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e: illustrates examples of the modifications of the research topics/questions to reflect the nearest meaning of the statement.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"905\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.353200883002206%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuote\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.86092715231788%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst interpretation of research topic/question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.211920529801326%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModified research topic/question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.573951434878587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.353200883002206%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e“If you can come up the with something, you know how to scrape off the nicotine before it destroy the original teeth.”\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.86092715231788%\" valign=\"top\"\u003e\n \u003cp\u003eHow can the effects of nicotine be reduced on teeth?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.211920529801326%\" valign=\"top\"\u003e\n \u003cp\u003eHow smoking can affect oral health?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.573951434878587%\" valign=\"top\"\u003e\n \u003cp\u003eThe patient seems to assume that the deposition of nicotine itself is a reason for their oral health issues which is not correct. However, smoking can affect it so we changed the question focusing on smoking and oral health rather than nicotine disposition which is a mechanism that does not connect these to\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.353200883002206%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e“…those days the doctors which I have gone to they are more professional and then nowadays sorry to say that the student their they don't understand English that well.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eAnd I gone through one experience in xxx Polyclinic I go for my check up and I attend for my Aerobic classes. This two European lady who just arrived Malaysia and she wants to go for a check-up. When she talk to the nurses they don’t understand no response to him and the wife. \u0026nbsp;The wife was surprised!”\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.86092715231788%\" valign=\"top\"\u003e\n \u003cp\u003eHow to improve English language communication of dental healthcare providers with patients?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.211920529801326%\" valign=\"top\"\u003e\n \u003cp\u003eHow to provide support for local dentists to communicate and engage with groups who have a different language?\u003c/p\u003e\n \u003cp\u003eWhat are the other characteristics a dentist needs to have to be accepted in that community e.g. some expressed that a dentist should be able to understand dentist to be considered a respected educated professional?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.573951434878587%\" valign=\"top\"\u003e\n \u003cp\u003eThe participant is an elderly lady whose grandfather was working for British during the colonial rule and assumes that a medical healthcare professional should know English and otherwise they are not fit to pursue their job effectively. Such behaviour is not uncommon in Malaysia which was once a British colony and the script of the national language, Bahasa Malaysia is English.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSome of the research ideas were not feasible due to existing regulatory issues. In such cases, we have modified the research questions to reflect the nearest research idea. An example for this is illustrated in Table 3.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e: illustrates an example of the modifications of the research topics/questions to reflect the nearest research idea.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"973\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.045267489711936%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuote\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.045267489711936%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst interpretation of research topic/question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.061728395061728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModified research topic/question\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.8477366255144%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.045267489711936%\" valign=\"top\"\u003e\n \u003cp\u003eParticipant: \u003cem\u003e“Doctor, I would like to ask you. Those days when I was at school, it is imagine I'm 66. So when I was in the primary school, which is below 12 years old, the school did the filling for me the black filling, it is so lasting until now. But the recent filling are not as strong as the olden days, so I also wonder why.”\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eI: \u003cem\u003e“So you want those black fillings to be ((Yeah)), re-established?”\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eP: \u003cem\u003e“Yes”.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.045267489711936%\" valign=\"top\"\u003e\n \u003cp\u003eCan we re-establish dental amalgam as a choice of restorative material?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.061728395061728%\" valign=\"top\"\u003e\n \u003cp\u003eHow to eliminate the dental amalgam related mercury toxicity in the environment?\u003c/p\u003e\n \u003cp\u003eHow to increase the durability and longevity of newer filling materials?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.8477366255144%\" valign=\"top\"\u003e\n \u003cp\u003eBased on the Minamata convention on Mercury 2014 report [9], dental amalgam needs to be phased out by year 2030. Therefore, the research questions were modified.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eProposed model\u003c/p\u003e\n\u003cp\u003eBased on our experience, we propose the following model (Figure 1) for translating participant opinions, views, research ideas or research priorities to research topics/questions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe model is summarised as follows:\u003c/p\u003e\n\u003cp\u003eIf research ideas – research priorities are expressed as explicit statements – can be translated to research topics – questions without much difficulty.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIf the statements are confusing, then we need to critically analyse the entire narrative and consider the pre- and post-interview discussions to determine the most likely research topic.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIf the statements are implicit, we should take the help of subject experts to interpret or verify the interpretation, consider the reason or justification for the research idea, and, if necessary, validate with a research committee and mark the final research topic/question as `implied´.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIf the statements are incomplete, researchers should determine the cause of the incomplete statements. If the reason is hesitation or fear, this can be verified in the reflexivity statements of the interviewer that aid in the completion of the research idea and thus determine the research topic-question. If the interviewer used any probes to obtain the complete statement, those probes were used for the better interpretation. If there are no other clues to complete the statements, leave such research ideas as empty and mark them.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn the Cochrane collaboration, JLA and NIHR PenARC (Peninsula Applied Research Collaboration) collected research topics/ questions in PICO format. However, not all stakeholders can comprehend their research ideas in such a format. It is indeed a challenging task to translate research priorities or research ideas from community participants into proper research questions that fit the PICO format [3], as the process involves interpretation and subjectivity. This process is not a simple linguistic translation but rather a translation of cultural issues. Furthermore, there is a paucity of literature providing guidance on the translation of research priorities. Our translation model can serve as a simple tool to assist research priority-setting groups in interpreting the research priorities or ideas put forth by community participants.\u003c/p\u003e\n\u003cp\u003eOur translation model is different from the guiding principles of topic refinement reported by Buckley et al [10]. The guiding principles of topic refinement were proposed for systematic reviews and consider the feasibility and relevance of the proposed research topics/ questions. However, we did not judge the proposed research ideas or priorities based on feasibility or relevance aspects in accordance with our three guiding principles.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn a Cochrane Oral Health Research Priority-Setting exercise [11], refinement of the research topics/questions was performed by a stakeholder committee with 30 members in the initial phase and was further refined by content experts in the implementation phase. However, the details of how the topics/questions were refined are not discussed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe priority research topics suggested by the participants may or may not address existing research gaps. Some research topics/questions may already be established or answered, and the participants may not be aware of this (referred to as an information gap or implementation gap). This research project's scope does not involve listing topics/questions that pertain to research gaps. Therefore, regardless of the type of suggestions made by the participants, we translated them into research topics/questions.\u003c/p\u003e\n\u003cp\u003eThroughout this process of interpreting and comprehending research topics/questions, the interview process played a significant role. As a natural part of the interviews, the interviewer-initiated conversations with greetings, self-introductions, explanations of the research project's purpose, and responses to any last-minute queries. Some participants provided examples of research topics/questions and inquired if they would fit the project. Others shared their dental problems, seeking consultation or guidance. A few participants were familiar to the interviewers as previous patients or acquaintances who had discussed dental issues in the past. These participants assumed that the interviewer would remember their dental concerns and based their statements on these assumptions. In some cases, these participants may have expressed themselves partially or given implicit statements, presuming that the interviewer would link them to previous dental treatment sessions and discussions. In such instances, relying solely on the interview transcripts for interpretation would not have been sufficient. Since these prior discussions were not recorded, the interviewers documented points in reflexivity statements whenever they believed these discussions would aid in a better interpretation of the interviews. These reflexivity notes proved valuable in deciphering some of the complex statements and establishing connections to the priority topics and reasons for prioritization.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFuture research priority setting activities should include detailed accounts of how they translated research priorities/ideas into research questions/topics, complete with examples and the challenges faced during this process. Such information will serve as a valuable guide for researchers in translating intricate narratives into meaningful research topics/questions.\u003c/p\u003e \u003cp\u003eAlthough our guidance model may not encompass all potential issues that a research priority setting group could encounter, it can be a useful tool for streamlining the process of translating research priorities or ideas.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eHuman Ethics and Consent to Participate declarations\u003c/p\u003e\n\u003cp\u003eThis study was approved in accordance with the Declarations of Helsinki by the Research and Ethics Committee of Melaka-Manipal Medical College, Melaka, Malaysia (Ref no. MMMC/FOM/Research Ethics Committee-2/2019 dated 15 September 2019) and the Ethics Committee of the University of Plymouth, Plymouth, United Kingdom (Ref no. 19/20 \u0026ndash; 1199 dated 11 March 2020 and 28 April 2020). Informed consent was obtained from all the participants and translators.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe have obtained consent from the participants and translators to share the anonymised data in publications, presentations and other scholarship activities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe complete list of research priorities and research topics/questions are available in the OSF data repository: https://osf.io/89ptj/?view_only=3577d32515d54ae789a7016dbe345df4\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eSumanth Kumbargere Nagraj: None\u003c/p\u003e\n\u003cp\u003eMona Nasser: None\u003c/p\u003e\n\u003cp\u003eRupert Jones: None\u003c/p\u003e\n\u003cp\u003eLynne Callaghan: None\u003c/p\u003e\n\u003cp\u003eCath Quinn: None\u003c/p\u003e\n\u003cp\u003eMartha Paisi: None\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis manuscript is part of the PhD work of Sumanth Kumbargere Nagraj and has not received any funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor contributions\u003c/p\u003e\n\u003cp\u003eSumanth Kumbargere Nagraj: conceptualisation, data collection, analysis and drafting of the manuscript\u003c/p\u003e\n\u003cp\u003eMona Nasser: conceptualisation, modifications of research topics/questions, proof reading and supervision of work\u003c/p\u003e\n\u003cp\u003eRupert Jones: modifications of research topics/questions, proofreading and supervision of work\u003c/p\u003e\n\u003cp\u003eLynne Callaghan: modifications of research topics/questions, proofreading and supervision of work\u003c/p\u003e\n\u003cp\u003eCath Quinn: modifications of research topics/questions, proofreading and supervision of work\u003c/p\u003e\n\u003cp\u003eMartha Paisi: modifications of research topics/questions, proofreading and supervision of work\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe authors thank the translators, Prof.Dr.Noorliza Mastura Ismail, Ms.Zainah Ibrahim, Dr.Hoe Fong, Dr.Tan Silk, Dr.Ming Yin, Dr.Bryan John Paulose and Mrs.Shanti Murugan who translated the interviews in the Bahasa Melayu and Mandarin languages and Dr.Lynn Varghese for helping in transcriptions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor information\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNasser M. Setting priorities for conducting and updating systematic reviews [dissertation on the internet]. University of Plymouth; 2018 [cited 2024 23 Feb 24]. Available from: https://pearl.plymouth.ac.uk/handle/10026.1/10849 \u003c/li\u003e\n\u003cli\u003eShah H, Albanese E, Duggan C, Rudan I, Langa KM, Carrillo MC, et al. Research priorities to reduce the global burden of dementia by 2025. Lancet Neurol. 2016;15:1285-94. doi: 10.1016/S1474-4422(16)30235-6.\u003c/li\u003e\n\u003cli\u003eJames Lind Alliance. Setting up a priority setting partnership. In: James Lind Alliance Guidebook. 2021. https://www.jla.nihr.ac.uk/jla-guidebook/downloads/JLA-Guidebook-Version-10-March-2021.pdf. Accessed 15 Feb 2024. \u003c/li\u003e\n\u003cli\u003eFranck LS, McLemore MR, Cooper N, De Castro B, Gordon AY, Williams S, et al. A novel method for involving women of colour at high risk for preterm birth in research priority setting. J Vis Exp [Internet]. 2018;12:131.\u003c/li\u003e\n\u003cli\u003eGross PH, Bailes AF, Horn SD, Hurvitz EA, Kean J, Shusterman M; et al. Setting a patient-centered research agenda for cerebral palsy: a participatory action research initiative. Dev Med Child Neurol. 2018 Dec;60:1278-84. doi: 10.1111/dmcn.13984. \u003c/li\u003e\n\u003cli\u003eMacFarlane A, Galvin R, O\u0026apos;Sullivan M, McInerney C, Meagher E, Burke D, et al. Participatory methods for research prioritization in primary care: an analysis of the World Caf\u0026eacute; approach in Ireland and the USA. Fam Pract. 2017;34:278-84. doi: 10.1093/fampra/cmw104.\u003c/li\u003e\n\u003cli\u003eWorld Health Organisation. A systematic approach for undertaking a research priority-setting exercise. Guidance for WHO staff. 2020. https://iris.who.int/bitstream/handle/10665/334408/9789240009622-eng.pdf?sequence=1. Accessed 21 Jan 2024.\u003c/li\u003e\n\u003cli\u003eBraun V., Clarke V. Thematic analysis: A practical guide. London: Sage; 2022. \u003c/li\u003e\n\u003cli\u003eBailey, Marianne (24 February 2014). \u0026quot;Minamata Convention on Mercury\u0026quot;. United States Environmental Protection Agency. Archived from the original on 19 October 2014. Accessed on 31 October 2023. \u003c/li\u003e\n\u003cli\u003eBuckley DI, Ansari MT, Butler M, Soh C, Chang CS. The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program. J Clin Epidemiol. 2014;67:425-32. doi: 10.1016/j.jclinepi.2013.10.023. \u003c/li\u003e\n\u003cli\u003eAnne Littlewood. Developing a framework for priority-setting in evidence synthesis: a case study of Cochrane Oral Health [dissertation on the internet]. Manchester: University of Manchester; 2022 [cited on 17 November 2023]. Available from: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.873918 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"health-research-policy-and-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrps","sideBox":"Learn more about [Health Research Policy and Systems](http://health-policy-systems.biomedcentral.com/)","snPcode":"12961","submissionUrl":"https://submission.nature.com/new-submission/12961/3","title":"Health Research Policy and Systems","twitterHandle":"@HarpsJournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Translation, research priority setting, research topics, research questions","lastPublishedDoi":"10.21203/rs.3.rs-4413817/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4413817/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: In the context of research priority setting, participants express their research priorities and ideas in various forms, ranging from narratives to explicit topics or questions. However, the transition from these expressions to well-structured research topics or questions is not always straightforward. Challenges intensify when research priorities pertain to interventions or diagnostic accuracy, requiring the conversion of narratives into the PICO (Participant, Intervention, Comparator, Outcome) format.\u003c/p\u003e\n\u003cp\u003eScope and findings: This project aimed to understand the challenges of engaging a diverse, multilingual population in setting oral health research priorities. While not a comprehensive priority-setting effort, we modified James Lind Alliance's (JLA) methods and used thematic analysis to establish a list of priority research topics and questions. This was accomplished by conducting interviews with 40 community participants and 14 dentists from various ethnic backgrounds in Malaysia. The interview language depended on participant preferences, including English, Malay, and Mandarin, with translations handled collaboratively by bilingual research assistants.\u003c/p\u003e\n\u003cp\u003eThe process involved thematic analysis, discussion with a research committee, and necessary modifications. Our interpretations revealed distinct categories of participant statements: explicit, complicated, implicit, and incomplete. In this study, we identified a three-step approach to translate research ideas that are presented either as explicit statements or as complicated narratives.\u003c/p\u003e\n\u003cp\u003eConclusions: Translating community research priorities poses inherent challenges. Our model, although not exhaustive, provides a valuable tool to assist research priority-setting groups in translating these priorities into meaningful research topics and questions, facilitating the equitable inclusion of diverse perspectives. Future research priority-setting endeavours should document their translation processes, thus aiding researchers in understanding and tackling the intricacies of this task.\u003c/p\u003e","manuscriptTitle":"Translation of oral health research priorities into research topics in an equity-based priority setting exercise","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-10 18:02:58","doi":"10.21203/rs.3.rs-4413817/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-10T20:25:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-13T09:07:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"75837402469058371467453033169669622902","date":"2024-05-23T08:30:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"286102607974090232287310420857710629161","date":"2024-05-22T22:13:22+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-22T22:06:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-22T13:23:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-22T13:23:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"Health Research Policy and Systems","date":"2024-05-13T14:17:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"health-research-policy-and-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrps","sideBox":"Learn more about [Health Research Policy and Systems](http://health-policy-systems.biomedcentral.com/)","snPcode":"12961","submissionUrl":"https://submission.nature.com/new-submission/12961/3","title":"Health Research Policy and Systems","twitterHandle":"@HarpsJournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2df5f584-5e6d-4bec-a01d-37e90e0fd040","owner":[],"postedDate":"June 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-01-27T16:04:24+00:00","versionOfRecord":{"articleIdentity":"rs-4413817","link":"https://doi.org/10.1186/s12961-024-01261-0","journal":{"identity":"health-research-policy-and-systems","isVorOnly":false,"title":"Health Research Policy and Systems"},"publishedOn":"2025-01-21 15:56:57","publishedOnDateReadable":"January 21st, 2025"},"versionCreatedAt":"2024-06-10 18:02:58","video":"","vorDoi":"10.1186/s12961-024-01261-0","vorDoiUrl":"https://doi.org/10.1186/s12961-024-01261-0","workflowStages":[]},"version":"v1","identity":"rs-4413817","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4413817","identity":"rs-4413817","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}