Health Research Priority Agenda for Ministry of Health, Kingdom of Saudi Arabia from 2020 to 2025.

METHOD: The current study applied e-Delphi technique via online self-administered questionnaire was distributing to headquarter, and 16 health affairs directorates spanning 75 hospitals and specialized health centers, 24 primary health-care centers, 2 health-care clusters, and 5 medical cities. In addition, community involvement was represented by 26 organizations: 7 universities, 9 scientific health associations, 5 charitable associations, and 5 key Saudi health partner organizations. Research field's prioritization was performed by ranking weighed mean aggregate score via application of the combined consensus and metrics-based approach. Then the top five research topics were analyzed, verified, refined and classified into specific health research themes. RESULTS: The study included 2252 participants and attained a 90% response rate. The study deliverables were listed into two research priority domains: health system research priorities (1st agenda) and diseases and health problems priorities (2nd agenda). Overall, the types of the top five research priorities in the first agenda included service delivery (40.9%), health workforce (14.4%), governance and leadership (13.0%) ,preparedness and response to disasters and emergency (10.2%), health information systems (9.3%), access to essential medicines products and vaccines (6.97%), and financing (5.1%). On the other hand, the top five research priority areas in the second agenda were non-communicable diseases (16.9%), child and neonatal health (15.9%), medications (13.6%), women health (10.4%), dental health (10.4%). furthermore, biomedical and radiology technology and devices (5.6%), communicable diseases (3.7%), nutrition (3.2%), trauma and general management (3.2%), innovative approaches (2.4%), emergency management (2.7%), physical therapy and rehabilitation (2.3%), public health (2.3%), holistic approaches to health and wellness, behavior and lifestyle (1.5%), environmental health (0.6%),pilgrims' health (0.6%), geriatric health (0.3%), and family medicine (0.3%). CONCLUSION: Adequate description of the stakeholders and methodology can strengthen legitimacy and credibility and maximize the impact of the priority-setting process. Involvement of policymakers, researchers and funding organizations increases the opportunity of translation into actual research, supports redesigning the research landscape and ensures uptake of results and integration.

Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review.

BACKGROUND: Cyclophosphamide is an alkylating agent associated with significant toxicities, most importantly hemorrhagic cystitis. Many approaches including mesna use were established to reduce this toxicity. However, data on mesna efficacy are conflicting. OBJECTIVE: To investigate the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide therapy with or without mesna. METHODS: A retrospective chart review was done on all adult patients receiving cyclophosphamide therapy with or without mesna at the King Saud University Medical City. The incidence of hemorrhagic cystitis was recorded. Patients receiving mesna were compared with those not receiving mesna. Data were reported as numbers and percentages, and appropriate statistical tests of association were used. This step was followed by a comprehensive literature review using appropriate keywords in PubMed from the inception of the database until August 2019. All studies of interest were reported. RESULTS: A total of 718 patients' medical records were reviewed. The majority of the patients received mesna (n = 433, 60%). The mesna group had a greater incidence of hemorrhagic cystitis (3.5% vs. 0.4%, p < 0.004) and received a significantly larger cumulative dose (3103 ± 1696 vs. 2465 ± 1528, p < 0.001) mg of cyclophosphamide therapy. Our literature review revealed large differences in the conclusions of published trials with highly diverse study designs and populations, emphasizing on the need of large prospective trials to address this topic.Conclusion and relevance: Our study results do not support the use of mesna in preventing hemorrhagic cystitis. We found that the only influential factor in the development of hemorrhagic cystitis was the dose of cyclophosphamide therapy.