Results
The AO Spine RECODE-DCM PSP recruited a total of 422 participants: 215 (50.9%) participants were randomised to the word cloud stream. Participants in the word cloud stream consisted of 118 (55%) spinal surgeons, 52 (24%) PwDCM and 45 (21%) oHCP. A total of 157 (73%) participants in the word cloud stream submitted additional uncertainties following word cloud presentation, including 86 (55%) spinal surgeons, 28 (18%) oHCP and 43 (27%) PwDCM. In total, participants submitted 434 additional research uncertainties after having reviewed the word clouds.The average word count of uncertainties per survey subsection (diagnosis, treatment, long-term management and other) were comparable between the non-word cloud stream and the word-cloud stream before word cloud presentation. However, after word cloud review word count of uncertainties was lower and more uniform across each subsection (Fig. Median number of words submitted per survey subsection (diagnosis, treatment, long-term management and other). Each group of bars represents subsections at different stages: without word clouds (grey), before word clouds (pale orange) and after word clouds (dark orange). Ordered from left to right, the bars represent diagnosis, treatment, long-term management and otherOf the 74 summary questions generated, 23 (32%) summary questions did not have a post-word-cloud contribution, and no summary question was formed based purely on an uncertainty generated after review of the word clouds. However, of the 434 research uncertainties made following word cloud review, only 108 (24.9%) were already represented in a participant’s submission prior to reviewing the word clouds and these uncertainties mapped to summary questions differently compared to those submitted prior to review of the word clouds (Fig. Radar plot of research uncertainties and how they map to the final 74 summary questions (black numbers) and top 26 priorities (green numbers), from uncertainties without (grey) or pre-word cloud (blue) compared to post-word cloud (orange). Post-word cloud uncertainties mapped to different research uncertainties than pre-word cloud uncertainties, including the number 1 research priority: raising awarenessIn addition, 5 summary questions appeared more likely to map to a participant’s research uncertainties following word cloud review. Two of these summary questions were subsequently ranked in the top 26 priorities, including the top research priority: raising awareness (Table Summary questions to which more uncertainties mapped after word cloud review. Numbers represent the number of responses