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Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method
  1. Adam Weir1,
  2. Per Hölmich1,2,
  3. Anthony G Schache3,
  4. Eamonn Delahunt4,
  5. Robert-Jan de Vos5
  1. 1Aspetar Sports Groin Pain Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
  3. 3Department of Mechanical Engineering, University of Melbourne, Melbourne, Australia
  4. 4School of Public Health, Physiotherapy & Population Science, University College Dublin, Dublin, Ireland
  5. 5Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Dr Robert-Jan de Vos, Department of Orthopaedics, Erasmus Medical Centre, PO Box 2040, Rotterdam 3000 CA, The Netherlands; r.devos{at}


Background Groin pain in athletes occurs frequently and can be difficult to treat, which may partly be due to the lack of agreement on diagnostic terminology.

Objective To perform a short Delphi survey on terminology agreement for groin pain in athletes by a group of experts.

Methods A selected number of experts were invited to participate in a Delphi questionnaire. The study coordinator sent a questionnaire, which consisted of demographic questions and two ‘real-life’ case reports of athletes with groin pain. The experts were asked to complete the questionnaire and to provide the most likely diagnosis for each case. Questionnaire responses were analysed by an independent researcher. The Cohen's κ statistic was used to evaluate the level of agreement between the diagnostic terms provided by the experts.

Results Twenty-three experts participated (96% of those invited). For case 1, experts provided 9 different terms to describe the most likely diagnosis; for case 2, 11 different terms were provided to describe the most likely diagnosis. With respect to the terms provided for the most likely diagnosis, the Cohen's κ was 0.06 and 0.002 for case 1 and 2, respectively. This heterogeneous taxonomy reflects only a slight agreement between the various diagnostic terms provided by the selected experts.

Conclusions This short Delphi survey of two ‘typical, straightforward’ cases demonstrated major inconsistencies in the diagnostic terminology used by experts for groin pain in athletes. These results underscore the need for consensus on definitions and terminology on groin pain in athletes.

  • Groin
  • Tendon
  • Muscle
  • Methodological
  • Consensus

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