The motivation for the project is straightforward: research priority setting determines which uncertainties get resolved before they matter. The authors argue that prioritizing research on epidemic measures can help ensure that studies address genuinely important questions rather than convenient ones, so that future decisions rest on better evidence. The work was carried out by the Centre for Epidemic Interventions Research, CEIR, a research centre embedded within the Norwegian Institute of Public Health that focuses on generating and synthesizing evidence about interventions used to control epidemics. Rather than letting individual researchers choose their own questions, the team built a structured process designed to capture the concerns of a broad range of Norwegian stakeholders and to apply transparent criteria for ranking what matters most.

The first methodological challenge was scope. Public health and social measures encompass a sprawling universe of interventions, from testing, isolation, contact tracing and quarantine to school closures, border restrictions, mask mandates, ventilation improvements and mass gathering limits. To map that landscape, the researchers conducted a literature review and solicited feedback from Norwegian stakeholders, ultimately assembling an exhaustive inventory of 173 distinct interventions. Because that list was far too large to interrogate question by question, they asked stakeholders to identify their top priorities, which narrowed the field to 22 interventions considered most relevant for the Norwegian setting. This filtering step anchored the entire exercise in what practitioners and decision-makers actually care about, rather than in what is easiest to study.

With the shortlist in hand, the team turned to established methods for surfacing research uncertainties. They drew on the nominal group technique, a structured facilitation method designed to elicit and rank ideas from participants in a way that limits the influence of dominant voices, and on approaches developed by the James Lind Alliance, a UK-based initiative known for bringing patients, clinicians and researchers together to agree on research priorities. Using these techniques with Norwegian stakeholders, the researchers collected raw proposals about what remains unknown or contested about the effects of the 22 priority interventions. The process generated 252 distinct questions, a volume that reflects how much legitimate uncertainty persists about measures that many governments deployed at enormous economic and social cost during the COVID-19 pandemic.

Turning 252 raw questions into a workable set required careful analytical work. The researchers applied thematic analysis, a qualitative method that groups similar items into overarching themes, combined with member checking, in which participants verify that the synthesized versions faithfully capture what they originally proposed. Through this process the 252 questions were consolidated into 76 research questions framed to capture the substance of the uncertainties stakeholders had raised. The consolidation was not merely editorial; each retained question needed to be answerable through research while preserving the intent of the people who raised it. The resulting list provides a systematic snapshot of where Norwegian stakeholders see the largest gaps between what is known about epidemic measures and what decision-makers need to know.

Prioritizing those 76 questions demanded explicit criteria rather than intuition. Drawing on a review of the literature and feedback from stakeholders, the team developed a set of twelve criteria against which each question could be judged, reflecting considerations such as the importance of the underlying decision, the size of the uncertainty, and the feasibility and likely impact of answering it. Thirteen members of the research team then independently applied these criteria to score and rank the questions. Using structured scoring by multiple assessors, rather than a single panel discussion, helps reduce the idiosyncrasies of individual judgment and makes the rationale for each ranking visible and auditable.

The scoring was not the final word. The team sought feedback from Norwegian stakeholders on the provisional priorities and incorporated that input into a consensus process within CEIR, which ultimately settled on a final list of sixteen prioritized research questions about the effects of public health and social measures. That iterative design, moving from broad stakeholder input to analytical consolidation to formal scoring and back to stakeholder consultation, reflects a core principle of evidence-informed priority setting: the people who will use or be affected by the research should have a genuine voice in what gets studied. It also mirrors lessons learned during COVID-19, when rapid evidence syntheses sometimes answered questions that were technically tractable but of limited practical value to policymakers.

A distinctive feature of the study is its attention to whether the priorities travel beyond Norway. The researchers presented the final list of sixteen questions to five external experts from Australia, Canada, Chile, the United States and the United Kingdom, using the TRANSFER framework, an approach developed for assessing the transferability of systematic review findings to different settings. This step acknowledges a persistent tension in pandemic research: measures such as school closures or contact tracing operate within specific health systems, legal frameworks and social contexts, so priorities identified in a high-capacity Nordic welfare state may differ from those in low- and middle-income countries. The external review offers an indication of how far the Norwegian list can serve as a starting point internationally, even though the questions were formulated for a national context.

The methodological machinery of the study, documented across nine appendices of supplementary material, is itself a contribution. By combining literature review, stakeholder consultation, nominal group technique, James Lind Alliance methods, thematic analysis, structured scoring against twelve criteria, and transferability assessment, the team produced a reproducible template that other national public health agencies could adapt. The study also navigated the ethical landscape of such work: because it did not constitute medical or health research under the Norwegian Health Research Act, it was exempt from review by the Regional Committees for Medical and Health Research Ethics, but the authors nevertheless followed established research ethics principles, including informed consent, anonymity and minimizing the burden of participation. The article is open access, published under a Creative Commons Attribution license, with no dedicated funding received for the work.

The implications reach well beyond Norway. The COVID-19 pandemic exposed how little rigorous evidence existed about the comparative effectiveness, unintended consequences and equity impacts of non-pharmaceutical interventions, and how quickly decisions must be made when evidence is thin. A pre-agreed list of priority questions can shape funding calls, trial designs, data collection infrastructure and rapid evidence synthesis efforts before the next crisis hits, so that answers are available when they are needed rather than years afterward. The sixteen prioritized questions will now guide the future work of the Centre for Epidemic Interventions Research, and the authors suggest the list may be useful to others in Norway and internationally as a starting point for setting their own research priorities. In effect, the study converts the scattered uncertainties of a global emergency into a disciplined research agenda, offering a concrete answer to a question that has haunted public health since 2020: when the next epidemic comes, what should we be studying right now?

Subject of Research: Research priority setting for public health and social measures to manage epidemics

Article Title: Research priorities for public health and social measures to manage epidemics: a multi-method consensus study in Norway

Article References: Munthe-Kaas, H. M., Elstrøm, P., Bruun, T., Bjørbaek, M., Elgersma, I. H., Flottorp, S., Fretheim, A., Gopinathan, U., Holst, C., Rosenbaum, S., Selstø, A., Solberg, R., & Oxman, A. D. (2026). Research priorities for public health and social measures to manage epidemics: a multi-method consensus study in Norway. BMC Public Health. https://doi.org/10.1186/s12889-026-29391-w

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29391-w

Keywords: public health and social measures, epidemic preparedness, pandemic preparedness, research priority setting, consensus methods, nominal group technique, James Lind Alliance, stakeholder engagement, non-pharmaceutical interventions, evidence-informed decision making, COVID-19, Norway

The study was led by Renee D. Rienecke of the Eating Disorders Education Institute in Miami and Northwestern University’s Department of Psychiatry and Behavioral Sciences, together with colleagues at the University of Calgary, Nova Southeastern University, and Galen Hope. The research team included clinicians, academic researchers, and individuals with lived experience of an eating disorder, a composition the authors viewed as critical. Training curricula have historically been designed largely by and for specialists, often leaving out the perspectives of patients and families who navigate the treatment system firsthand. By weighting the judgments of all three groups equally in a formal consensus process, the study sought to build a curriculum that reflects the realities of care rather than the preferences of any single professional community.

The Delphi method, the technique at the heart of the study, is a well-established approach for building consensus among experts who never meet face to face. Participants rate a series of statements independently, the results are aggregated and fed back to the group, and the rating process repeats until stability emerges. This design minimizes the influence of dominant personalities and institutional hierarchies that can distort in-person consensus meetings. In this study, the panel worked through 124 candidate items in the first round, rating each on a five-point scale of importance for inclusion in an introductory course. Predefined quantitative thresholds determined whether an item was endorsed, rejected, or sent forward for re-rating, and participants could also propose topics the researchers had not thought to include.

Those write-in options proved to be one of the study’s most revealing features. Content analysis of the free-text suggestions generated new categories and items that the original item pool had overlooked, including a cluster the researchers labeled myths, misconceptions, and stereotypes about eating disorders. That addition underscores a persistent problem in the field: eating disorders are still widely mischaracterized as illnesses of affluent young women, as vanity-driven choices, or as attention-seeking behaviors, misconceptions that delay diagnosis and discourage help-seeking across demographics. Panelists evidently judged that dismantling these stereotypes belongs at the very beginning of training, before any discussion of diagnostic criteria or treatment technique.

The quantitative results traced a clear arc across the three rounds. In round one, 49 of the 124 items met the endorsement threshold while 41 were rejected outright, with the remainder held for further evaluation. Round two added 25 more endorsed items and 10 more rejections, and the final round contributed 11 additional endorsements and 21 rejections, bringing the totals to 85 endorsed and 72 rejected items. The re-rating rounds were not merely mechanical: in round three, participants received feedback on how the full panel had rated each item in the previous round, allowing them to calibrate their own judgments against the collective view. This iterative feedback loop is precisely what gives the Delphi method its power to converge on genuine group consensus rather than averaging isolated opinions.

Perhaps the most striking single finding concerned treatment modalities. Of 20 treatment approaches or components presented to the panel, only two survived the consensus process: family-based treatment, often abbreviated FBT, and psychoeducation. Family-based treatment is an evidence-based approach in which parents are empowered to take a central role in restoring their adolescent’s nutrition and weight, and it has accumulated strong empirical support for adolescent anorexia nervosa in particular. Psychoeducation, the systematic teaching of patients and families about the nature, mechanisms, and course of eating disorders, is a component woven through nearly every credible treatment model. That the panel endorsed only these two from a list that implicitly included modalities such as cognitive-behavioral therapy, enhanced cognitive-behavioral therapy, and dialectical behavior therapy is a deliberate signal about scope: an introductory course, the panel concluded, should teach trainees to recognize these specialized therapies and understand when to refer, not attempt to train novice learners to deliver them.

This distinction between awareness and competence carries real clinical weight. Eating disorders frequently present first in primary care, pediatrics, dentistry, school counseling, and emergency settings, where professionals may have received only hours of relevant education during their entire training. The diagnostic signs can be subtle, including changes in weight or growth curves, ritualized eating, excessive exercise, electrolyte abnormalities, and enamel erosion, and the illnesses themselves are marked by secrecy and minimization. A trainee who has absorbed a well-constructed introductory curriculum can screen effectively, avoid stigmatizing language, initiate a medical risk assessment, and make a timely referral to specialist care. A trainee who has not may miss the illness entirely or, worse, deliver well-intentioned advice that exacerbates it. The consensus list effectively defines the floor of knowledge every such frontline professional should possess.

The study’s methods also reflect contemporary standards for consensus research. Quantitative decisions about endorsement and rejection were governed by criteria fixed in advance, protecting the results from post hoc judgment calls, while the qualitative analysis of write-in items followed structured content-analysis procedures before those items entered the second round. The research received ethics approval from the Biomedical Research Alliance of New York Institutional Review Board, and all participants provided informed consent. The work was funded by the Eating Disorders Education Institute, and the authors declared no competing interests. Published as open access, the full item-level results are available to educators, professional societies, and training programs that wish to build on them.

The international context sharpens the significance of the findings. Bodies such as the Australia and New Zealand Academy for Eating Disorders have moved further than their American counterparts in codifying expectations for eating disorder competency among clinicians, and workforce documents in the United Kingdom have similarly articulated core capabilities. The United States, by contrast, has had no widely agreed-upon guideline for what introductory eating disorder education should contain, leaving curriculum design to individual institutions and instructors with predictably uneven results. A consensus-derived topic list of 85 items gives American educators, and educators elsewhere, an evidence-informed starting point that can be adapted for medical students, nursing curricula, psychology internships, dietetic programs, social work training, and continuing education for practicing clinicians.

The authors are candid that the list is a foundation rather than a finished curriculum. Endorsement by a Delphi panel establishes that a topic matters; it does not specify how deeply each topic should be taught, in what sequence, or with what pedagogical methods, and the panel’s conclusions describe an introductory course rather than advanced specialist training. Future work will need to translate the 85 endorsed topics into actual course content, evaluate learning outcomes, and test whether graduates of such courses demonstrably improve detection and referral of eating disorders in real clinical settings. Still, the study resolves a deceptively simple question that the field had never systematically answered: what must every newcomer to this area know? With a diverse panel of clinicians, researchers, and people with lived experience now on record, the answer no longer depends on who happens to be designing the syllabus. For a field in which early intervention measurably improves outcomes, a shared, expert-validated map of essential knowledge may prove to be one of the most consequential educational tools the eating disorders community has produced.

Subject of Research: Expert consensus on essential topics for an introductory training course on identifying and treating eating disorders

Article Title: Identifying Essential Topics for an Introductory Training Course on Eating Disorders:

Article References: Rienecke, R. D., Borkenhagen, D., Carde, B., Dimitropoulos, G., Singh, M., Mensinger, J., Turner, C., & Oliver-Pyatt, W. (2026). Identifying Essential Topics for an Introductory Training Course on Eating Disorders:. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01758-9

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01758-9

Keywords: eating disorders, Delphi study, training curriculum, family-based treatment, psychoeducation, consensus methods, clinician education, anorexia nervosa, lived experience, medical education, early intervention, stigma