RT Journal Article
SR Electronic
T1 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
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 444
OP 451
DO 10.1136/bjsports-2019-100894
VO 54
IS 8
A1 Bill Vicenzino
A1 Robert-Jan de Vos
A1 Hakan Alfredson
A1 Roald Bahr
A1 Jill L Cook
A1 Brooke K Coombes
A1 Siu Ngor Fu
A1 Karin Gravare Silbernagel
A1 Alison Grimaldi
A1 Jeremy S Lewis
A1 Nicola Maffulli
A1 SP Magnusson
A1 Peter Malliaras
A1 Sean Mc Auliffe
A1 Edwin H G Oei
A1 Craig Purdam
A1 Jonathan D Rees
A1 Ebonie Kendra Rio
A1 Alex Scott
A1 Cathy Speed
A1 Inge van den Akker-Scheek
A1 Adam Weir
A1 Jennifer Moriatis Wolf
A1 Johannes Zwerver
YR 2020
UL http://bjsm.bmj.com/content/54/8/444.abstract
AB 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).