title: Community consultation in emergency neurosurgical research: lessons from a proposed trial for patients with chronic subdural haematomas.
abstract: BACKGROUND
  Chronic subdural haematoma (CSDH) is one of the most common neurosurgical disorders and is especially prevalent in old age. The subdural evacuating port system (SEPS) has emerged in the last few years as a minimally invasive alternative to the standard procedure of burr-hole evacuation. NHS practice is evidence-driven and evidence from high-quality clinical studies is required prior to implementation of any changes. In the UK, the National Research Ethics Service (NRES) advises community consultation prior to starting a clinical trial, where the patient is unlikely to have capacity to consent to enrolment in the trial. To prepare for a trial comparing minimally invasive (SEPS) versus burr-hole evacuation for evacuation of a CSDH, we have designed and undertaken a pre-protocol community consultation survey to examine potential patient participation. MATERIAL(S) AND METHODS: The study population consisted of patients, family members and carers/friends in neurosurgical clinic waiting rooms and wards at Addenbrooke's Hospital, Cambridge, who individually completed a questionnaire (n = 215).
  
  
  RESULTS
  Most respondents were willing to participate in the proposed randomised clinical trial (77%; 165/215). Moreover, 80% (171/215) and 74% (159/215) were willing to allow their next of kin and an independent consultant neurosurgeon to give surrogate consent, respectively.
  
  
  CONCLUSIONS
  The results of our pre-protocol community consultation showed that not only would most respondents be willing to participate in the proposed trial, but also would be happy for either next of kin or an independent consultant neurosurgeon to give surrogate consent if they lacked capacity to consent themselves. The advantages of this type of survey are twofold: they increase patient and public involvement in the research process and allow researchers to design study protocols that are acceptable to the community.
authors.affiliation: Division of Neurosurgery, Addenbrooke's Hospital & University of Cambridge, Cambridge, UK.
authors.forename: William J
authors.initials: WJ
authors.lastname: Scotton
authors.forename: Angelos G
authors.initials: AG
authors.lastname: Kolias
authors.forename: Vin Shen
authors.initials: VS
authors.lastname: Ban
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Crick
authors.forename: Rohitashwa
authors.initials: R
authors.lastname: Sinha
authors.forename: Andrew
authors.initials: A
authors.lastname: Gardner
authors.forename: Kate
authors.initials: K
authors.lastname: Massey
authors.forename: Thais
authors.initials: T
authors.lastname: Minett
authors.forename: Thomas
authors.initials: T
authors.lastname: Santarius
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hutchinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D020458:Third-Party Consent; D055815:Young Adult