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ICON 2019—International Scientific Tendinopathy Symposium Consensus: There are nine core health-related domains for tendinopathy (CORE DOMAINS): Delphi study of healthcare professionals and patients

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Author
Vicenzino, Bill
de Vos, Robert-Jan
Alfredson, Hakan
Bahr, Roald
Cook, Jill L.
Coombes, Brooke K.
Ngor Fu, Siu
Gravare Silbernagel, Karin
Grimaldi, Alison
Lewis, Jeremy
Maffuli, Nicola
Magnusson, S.P.
Malliaras, Peter
Mc Auliffe, Sean
Oei, Edwin H.G.
Purdam, Craig
Rees, Jonathan
Rio, Ebonie Kendra
Scott, Alex
Speed, Cathy
Date
2019-11-04
Acceptance date
2019-09-15
Type
Article
Publisher
BMJ Publishing Group
ISSN
1473-0480
Metadata
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Abstract
Background: The absence of any agreed-upon tendon health-related domains hampers advances in clinical tendinopathy research. This void means that researchers report a very wide range of outcome measures inconsistently. As a result, substantial synthesis/meta-analysis of tendon research findings is almost futile despite researchers publishing busily. We aimed to determine options for, and then define, core health-related domains for tendinopathy. Methods: We conducted a Delphi study of healthcare professionals (HCP) and patients in a three-stage process. In stage 1, we extracted candidate domains from clinical trial reports and developed an online survey. Survey items took the form: ‘The ‘candidate domain’ is important enough to be included as a core health-related domain of tendinopathy’; response options were: agree, disagree, or unsure. In stage 2, we administered the online survey and reported the findings. Stage 3 consisted of discussions of the findings of the survey at the ICON (International Scientific Tendinopathy Symposium Consensus) meeting. We set 70% participant agreement as the level required for a domain to be considered ‘core’; similarly, 70% agreement was required for a domain to be relegated to ‘not core’ (see Results next). Results: Twenty-eight HCP (92% of whom had >10 years of tendinopathy experience, 71% consulted >10 cases per month) and 32 patients completed the online survey. Fifteen HCP and two patients attended the consensus meeting. Of an original set of 24 candidate domains, the ICON group deemed nine domains to be core. These were: (1) patient rating of condition, (2) participation in life activities (day to day, work, sport), (3) pain on activity/loading, (4) function, (5) psychological factors, (6) physical function capacity, (7) disability, (8) quality of life and (9) pain over a specified time. Two of these (2, 6) were an amalgamation of five candidate domains. We agreed that seven other candidate domains were not core domains: range of motion, pain on clinician applied test, clinical examination, palpation, drop out, sensory modality pain and pain without other specification. We were undecided on the other five candidate domains of physical activity, structure, medication use, adverse effects and economic impact. Conclusion: Nine core domains for tendon research should guide reporting of outcomes in clinical trials. Further research should determine the best outcome measures for each specific tendinopathy (ie, core outcome sets).
Journal/conference proceeding
British Journal of Sports Medicine;
Citation
Vicenzino, B. et al. (2019) 'ICON 2019—International Scientific Tendinopathy Symposium Consensus: There are nine core health-related domains for tendinopathy (CORE DOMAINS): Delphi study of healthcare professionals and patients', British Journal of Sports Medicine. DOI: 10.1136/bjsports-2019-100894.
URI
http://hdl.handle.net/10369/10893
DOI
http://dx.doi.org/10.1136/bjsports-2019-100894
Description
Article published in British Journal of Sports Medicine on 04 November 2019 (online), available at: http://dx.doi.org/10.1136/bjsports-2019-100894.
Rights
https://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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  • Sport Research Groups [1088]

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