Mobilising the experiential knowledge of clinicians, patients and carers for applied health-care research

摘要

This article demonstrates the benefits of combining various types of knowledge for applied health research. Funding is available for health research despite these being 'austere times' for public services and international policy shifts recognise the role that patients, carers and the public can play in research. In England the National Institute for Health Research, Research Design Service (RDS) was created to ensure that the experiential knowledge of clinicians working in the National Health Service is informed by methodological expertise to achieve relevant research outcomes. The RDS also facilitates patient and public involvement in research, framed as 'PPI'. This raises the question of how PPI impacts on research design and funding and which patients or members of the public should be involved in which aspects of research. To answer these questions we present case studies that draw on the expertise of academics, clinicians, patients and the public in applied health research. These cases demonstrate that where patients with direct experience of the condition that is to be studied are actively involved as advisers early on in applied health research, this can enhance the likelihood of successful funding applications, ethical aspects of research and the relevance of questionnaires and interventions to patients. For comparative purposes, we give an example of an unsuccessful research proposal. We contribute to theoretical development through refining the conceptualisation of PPI by unpicking the different roles that members of the public play as lay people, distinguishing this from the specific expertise that comes from direct experience of being a service user, carer or patient. We conclude that different types of knowledge are required for applied health research: methodological expertise, practice-based expertise, and the experiential expertise of patients or carers. While there are no guarantees, the scrutiny function performed by lay involvement in research funding panels can challenge the balance of power.