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Expanding PPIE - Patient and Public Involvement and Engagement in Research

Three Part Question

How can we expand [PPIE (patient and public involvement and engagement)] with [improved inclusivity] to [enhance patient directed research]?

Clinical Scenario

A 78 year old man with chest pain presents to the ED accompanied by his daughter. He is recluctant to wear his hearing aid and is reliant on his daughter to communicate. You wish to be confident in assessing his level of chest pain and wonder if there were tools to get a more accurate pain score direct from the patient

Search Strategy

The search was carried out using Medline, Social Policy and Practice and Health Service Premium Collection.

Time frame: 2012-2022

Language preference: English

Synonyms used:

Emergency Department, Accident and Emergency, A&E, ED, Emergency Room, ER, Urgent Care, Emergency Medicine, Emergency Care

Patient and public involvement and engagement, stakeholder analysis, feedback, forum, PPIE, expert, advisory group, board, advisor, social responsibility, activity, inclusivity


1 ((patient and public involvement and engagement) or PPIE).ti,ab. (28)
2 (patient and public involvement and engagement).mp. [mp=abstract, title, publication type, heading word, accession number] (29)
3 1 or 2 (29)
4 Emergency Department*.ti,ab. (454)
5 (Accident and Emergency).ti,ab. (275)
6 (A&E or ED).ti,ab. (628)
7 (Emergency Room, or ER).ti,ab. (104)
8 Urgent Care.ti,ab. (61)
9 (Emergency and (Medicine or care)).ti,ab. (1202)
10 ((Patient* or public) and (involvement or engagement)).ti,ab. (2995)
11 3 or 10 (2995)
12 4 or 5 or 6 or 7 or 8 or 9 (1981)
13 inclusive.ti,ab. (2614)
14 patient* focus* research priorit*.ti,ab. (0)
15 13 or 14 (2614)
16 11 and 12 and 15 (0)
17 11 or 15 (5545)
18 12 and 17 (48)
19 stakeholder analysis.ti,ab. (6)
20 feedback.ti,ab. (2539)
21 forum*,ti, [mp=abstract, title, publication type, heading word, accession number] (0)
22 13 or 14 or 19 or 20 or 21 (5127)
23 11 and 12 and 22 (4)
24 11 or 22 (8003)
25 12 and 24 (78)
26 3 or 25 (107)

Search Outcome

OVID results: 107
MEDLINE results: 140
1 study addressed the question

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Hirst, E., et al.
N/AConcept ArticleReflected upon the PPIE used in 14 Emergency Department and Pre-Hospital studies. Reflected upon the formulation of an Emergency Care Forum and the challenges that it has faced. Recommends PPIE be included when priority setting in research with other professional and charitable organisations.Concept article that mostly opinion based. Limited number of studies reflected on.


Several studies found during the literature search linked to the topic but did not directly address the identified question. These included studies that used PPIE methods in ED such as focus groups. One study reflected upon PPIE in setting priorities for Cochrane Reviews. There were also two articles that covered specific inclusive PPIE methods, both studies were based in the USA and were specific to HIV and one for veteran inclusion. And finally, a study was reflecting on PPIE method changes in COVID but again, not specific to ED.

Clinical Bottom Line

The literature search has failed to identity an adequate number of studies to answer the question and further research is needed.


  1. Hirst E, Irving A, Goodacre S. Patient and public involvement in emergency care research. Emergency Medicine Journal 2016;33:665-670.