Pulmonary Hypertension (Canada) PSP Question Verification Form

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

Pulmonary Hypertension Priority Setting Partnership (Canada)

Please describe the scope of the PSP

The aim of the Pulmonary Hypertension PSP is to identify the most important unanswered questions and uncertainties about the diagnosis, treatment, and prognosis of pulmonary hypertension (PH) from the perspective of patients, caregivers, as well as policy-makers and clinicians involved in PH care and then prioritise those that patients, carers and clinicians agree are the most important for research to address.

The scope of the PH PSP pertained to adults with PH and questions about 1) diagnosis of PH, 2) treatment 3) prognosis, 4) causes and risk factors for PH, 5) physical or emotional impact of pulmonary hypertension
The PH PSP excluded from its scope questions about pediatric PH.

Please provide a brief overview of your approach to checking whether the questions were unanswered

Given the broad scope of the PH PSP we performed a systematic literature search including systematic reviews, scoping reviews, and guidelines. We also evaluated randomized controlled trials and observational studies but did not consider these as definitively answering a question.

Please list the type(s) of evidence you used to verify your questions as unanswered

Systematic reviews, scoping reviews, clinical guidelines.

Please list the sources that you searched in order to identify that evidence

Ovid MEDLINE, EBM Reviews – Cohrane Database of Systematic Reviews, Embase.

What search terms did you use?

Search strategies for each search below:
Database: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations and Daily <1946 to September 02, 2021>
Search Strategy:
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1 exp Hypertension, Pulmonary/ (38438)
2 (pulmonary adj3 hypertensi*).tw,kf. (50554)
3 1 or 2 (58315)
4 limit 3 to (english language and yr="2010 -Current") (27691)
5 limit 4 to (meta analysis or "systematic review") (413)
6 (meta analys* or metanalys* or metaanalys*).tw,kf. (210360)
7 ((critical or integrative or systematic) adj3 (review* or overview* or synthesis)).tw,kf. (256795)
8 6 or 7 (364943)
9 4 and 8 (569)
10 5 or 9 (618)
11 Critical Pathways/ (7237)
12 Clinical Protocols/ (29273)
13 consensus development conference/ (12112)
14 guideline/ or practice guideline/ (36156)
15 ((critical or clinical or practice) adj2 (pathway* or protocol* or standards)).ti,kf. (5861)
16 guideline*.ti,kf. (93922)
17 11 or 12 or 13 or 14 or 15 or 16 (161807)
18 4 and 17 (240)
19 limit 4 to (consensus development conference or guideline or practice guideline) (92)
20 10 or 18 or 19 (839)
21 animals/ not humans/ (4847743)
22 20 not 21 (833)

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Database: EBM Reviews - Cochrane Database of Systematic Reviews <2005 to September 01, 2021>
Search Strategy:
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1 hypertension, pulmonary.kw. (16)
2 (pulmonary adj3 hypertension).ti,ab. (26)
3 1 or 2 (29)
4 limit 3 to last 10 years (22)

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Database: Embase <1974 to 2021 September 02>
Search Strategy:
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1 exp pulmonary hypertension/ (98743)
2 (pulmonary adj3 hypertensi*).tw,kw. (83167)
3 1 or 2 (110845)
4 limit 3 to yr="2010 -Current" (74282)
5 limit 4 to english language (71526)
6 limit 5 to conference abstract (28514)
7 5 not 6 (43012)
8 animals/ not human/ (934675)
9 7 not 8 (42858)
10 limit 9 to (meta analysis or "systematic review") (838)
11 (meta analys* or metanalys* or metaanalys*).tw,kw. (273779)
12 ((critical or integrative or systematic) adj3 (review* or overview* or synthesis)).tw,kw. (314474)
13 11 or 12 (460767)
14 9 and 13 (787)
15 10 or 14 (1053)
16 ((critical or clinical or practice) adj2 (pathway* or protocol* or standards)).ti,kw. (8572)
17 guideline*.ti,kw. (133116)
18 16 or 17 (141140)
19 9 and 18 (364)
20 limit 9 to consensus development (69)
21 15 or 19 or 20 (1438)

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Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

Limited to English language, time limited to 2010 – 2021 September 02, humans.
Due to the PSP timeline and number of studies anticipated, English studies were only included.
Due to the rarity of PH and slower evolution in evidence development we used an 11 year time span to maximize the number of systematic reviews retrieved.

Names of individuals who undertook the evidence checking

Jason Weatherald, Hina Iqbal, Abdul Rehman Syed

On what date was the question verification process completed?

December 18, 2021

Any other relevant information

We screened 1611 articles and retrieved 417 articles. Nineteen were not retrievable. 398 articles were assessed for eligibility and 352 were included in the evidence check and mapped to the 187 indicative questions. 30 questions were found to be adequately answered by existing systematic reviews, scoping review, or guidelines. 157 questions were carried forward to the interim survey.