Research Priorities for the Pan-Canadian Oncology Symptom Triage and Remote Support Practice Guides: A Modified Nominal Group Consensus

Introduction: The pan-Canadian Oncology Symptom Triage and Remote Support (costars) team is studying how to improve the quality and consistency of cancer symptom management. Methods: A 1-day invitational meeting was held 24 October 2017 in Ottawa, Ontario, to review the current evidence from costars projects and to establish research priorities for a future largescale implementation study. The meeting included 36 participants who were clinicians from adult oncology, pediatric oncology, and homecare; policymakers from national, provincial, and regional organizations; researchers; and a patient. Half the day involved summarizing evidence from four costars studies and experiences with implementing the costars symptom practice guides. The second half of the day used a modified nominal group technique to generate research questions within small groups, presentation of research questions to all participants, and two rounds of voting to reach consensus on research priorities. Results: Participants proposed 4 research categories: (1) User-centred augmentation to enhance usability (for example, designing a mobile costars solution); (2) Outcome measurement (for example, determining key competencies for clinicians); (3) Regular renewal of costars to keep pace with evolving evidence (for example, updates for novel therapies); (4) Integration into clinical practice (for example, meaningful engagement of patients and caregivers in study design). Conclusions: Across categories, the top 3 priorities were effect on health services use, competency development, and a mobile costars solution. Future research will address identified priorities, reflecting the needs and perspectives of diverse stakeholders. Stakeholder collaboration will continue to guide our approach to operationalizing this priority research agenda.