Setting priorities in clinical and health services research: Properties of an adapted and updated method

Objectives: The objectives of this study is to review the set of criteria of the Institute of Medicine (IOM) for priority-setting in research with addition of new criteria if necessary, and to develop and evaluate the reliability and validity of the final priority score. Methods: Based on the evaluation of 199 research topics, forty-five experts identified additional criteria for priority-setting, rated their relevance, and ranked and weighted them in a three-round modified Delphi technique. A final priority score was developed and evaluated. Internal consistency, test–retest and inter-rater reliability were assessed. Correlation with experts’ overall qualitative topic ratings were assessed as an approximation to validity. Results: All seven original IOM criteria were considered relevant and two new criteria were added (“potential for translation into practice”, and “need for knowledge”). Final ranks and relative weights differed from those of the original IOM criteria: “research impact on health outcomes” was considered the most important criterion (4.23), as opposed to “burden of disease” (3.92). Cronbach’s alpha (0.75) and test–retest stability (interclass correlation coefficient = 0.66) for the final set of criteria were acceptable. The area under the receiver operating characteristic curve for overall assessment of priority was 0.66. Conclusions: A reliable instrument for prioritizing topics in clinical and health services research has been developed. Further evaluation of its validity and impact on selecting research topics is required

Bifurcation of relative equilibria of the (1+3)-body problem

We study the relative equilibria of the limit case of the pla- nar Newtonian 4{body problem when three masses tend to zero, the so-called (1 + 3){body problem. Depending on the values of the in- nitesimal masses the number of relative equilibria varies from ten to fourteen. Always six of these relative equilibria are convex and the oth- ers are concave. Each convex relative equilibrium of the (1 + 3){body problem can be continued to a unique family of relative equilibria of the general 4{body problem when three of the masses are su ciently small and every convex relative equilibrium for these masses belongs to one of these six families.