ICON 2023: International Scientific Tendinopathy Symposium Consensus – the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients,British Journal of Sports Medicine

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ICON 2023: International Scientific Tendinopathy Symposium Consensus – the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients
British Journal of Sports Medicine ( IF 11.6 ) Pub Date : 2024-10-01 , DOI: 10.1136/bjsports-2024-108263
Robert-Jan de Vos ₁ , Karin Gravare Silbernagel ₂ , Peter Malliaras ₃ , Tjerk Sleeswijk Visser _{4,

5} , Hakan Alfredson ₆ , Inge van den Akker-Scheek ₇ , Mathijs van Ark ₈ , Annelie Brorsson ₉ , Ruth Chimenti ₁₀ , Sean Docking ₁₁ , Pernilla Eliasson ₉ , Kenneth Farnqvist ₁₂ , Zubair Haleem _{13,

14} , Shawn L Hanlon ₁₅ , Jean-Francois Kaux _{16,

17} , Rebecca Samantha Kearney ₁₈ , Paul D Kirwan _{19,

20} , Kornelia Kulig ₂₁ , Bhavesh Kumar ₂₂ , Trevor Lewis ₂₃ , Umile Giuseppe Longo ₂₄ , Tun Hing Lui ₂₅ , Nicola Maffulli ₂₆ , Adrian James Mallows ₂₇ , Lorenzo Masci ₂₈ , Dennis McGonagle _{29,

30} , Dylan Morrissey _{31,

32} , Myles Calder Murphy _{33,

34} , Richard Newsham-West ₃₅ , Katarina Maria Nilsson-Helander ₃₆ , Richard Norris _{37,

38} , Francesco Oliva ₃₉ , Seth O'Neill ₄₀ , Koen Peers ₄₁ , Ebonie Kendra Rio ₄₂ , Igor Sancho ₄₃ , Alex Scott ₄₄ , Kayla D Seymore ₂ , Sze-Ee Soh ₄₅ , Patrick Vallance ₄₆ , Jan A N Verhaar ₁ , Arco C van der Vlist ₁ , Adam Weir _{47,

48} , Jennifer Ann Zellers ₄₉ , Bill Vicenzino ₅₀

Affiliation

Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
Physiotherapy Department, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia.
Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Sports Medicine, HMC Antoniushove Stichting Haaglanden Medisch Centrum, Leidschendam, The Netherlands.
Department of Community Medicine and Rehabilitation, Sports Medicine, Umea University Faculty of Medicine, Umea, Sweden.
Department of Orthopedics, University Medical Centre, Groningen, The Netherlands.
Physiotherapy Department, School of Health Care Studies, Hanze University of Applied Sciences, Groningen, The Netherlands.
Department of Orthopedics, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden.
Department of Physical Therapy and Rehabilitation Sciences, The University of Iowa, Iowa City, Iowa, USA.
Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Sports and Exercise Medicine, Queen Mary University, London, UK.
Arsenal Football Club, London, UK.
Department of Kinesiology, California State University Fullerton, Fullerton, California, USA.
Physical Medicine and Sport Traumatology Department, University of Liege, Liege, Belgium.
FIMS Collaborative Centre of Sports Medicine, FIFA Medical Centre of Excellence, Dubai, UAE.
Bristol Trials Centre, University of Bristol, Bristol, UK.
Discipline of Physiotherapy, School Of Medicine, Trinity College Dublin, Dublin, Ireland.
Physiotherapy Dept, Connolly Hospital Blanchardstown, Blanchardstown, Ireland.
Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA.
Fortius Clinic, London, UK.
Liverpool Foundation Trust, Aintree University Hospital, Liverpool, UK.
Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Department of Orthopaedic and Traumatology, North District Hospital, Hong Kong, Hong Kong.
Department of Trauma and Orthopaedics, School of Medicine and Psychology, University of Rome La Sapienza, Rome, Italy.
School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK.
Institute of Sport Exercise and Health (ISEH), University College London, London, UK.
Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds Leeds, Leeds, UK.
Leeds Biomedical Research Centre, Leeds, UK.
Sport and Exercise Medicine, Queen Mary University, London, UK.
Physiotherapy Department, Barts Health NHS Trust, London, UK.
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
School of Health Sciences, The University of Notre Dame, Fremantle, Western Australia, Australia.
Australian Physiotherapy Association, Hawthorn, Victoria, Australia.
Department of Orthopaedics, Sahlgrenska University Hospital, Goteborg, Sweden.
Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
The Physiotherapy Centre, Liverpool, UK.
Department of Human Sciences and Promotion of the Quality of Life, University of Rome La Sapienza, Rome, Italy.
School of Healthcare, College of Life Sciences, University of Leicester, Leicester, UK.
Department of Development and Regeneration, KU Leuven - University, Leuven, Belgium.
La Trobe Sport and Exercise Medicine Research Centre, The Australian Ballet, The Victorian Institute of Sport, La Trobe University, Bundoora, Victoria, Australia.
Deusto Physical TherapIker, Physiotherapy Department, Faculty of Health Sciences, University of Deusto, Bilbao, Spain.
Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada.
Department of Physiotherapy and Rehabilitation, Monash University Rehabilitation Ageing and Independent Living Research Centre, Frankston, Victoria, Australia.
Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Clayton, Victoria, Australia.
Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar.
Sport Medicine and Exercise Clinic (SBK), Haarlem, The Netherlands.
Program in Physical Therapy & Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Physiotherapy, The University of Queensland School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.

To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0–10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0–10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement.

中文翻译：

ICON 2023：国际肌腱病科学研讨会共识 – 使用系统评价和对专业参与者和患者的 Delphi 研究确定跟腱病（COS-AT）的核心结果

为了开发用于临床试验的跟腱病核心结局集（COS-AT），我们执行了一个五步过程，包括（1）对可用结果测量工具的系统评价，（2）对可用测量工具的真实性和可行性的在线调查，（3）对所选结果测量工具的方法学质量的评估，（4）对结果测量工具作为 COS 的在线调查，以及（5）共识面对面会议。这两项调查均由医疗保健专业人员和患者完成。遵循风湿病学指南结局测量，共识阈值为 70%。我们从 307 项纳入研究中确定了 233 种不同的结局测量工具;177 项被映射到国际科学肌腱病研讨会共识核心领域内。31 名参与者（12 名患者）完成了第一次在线调查（回复率 94%）。22/177 （12%）的结果测量工具被认为是真实可行的，并评估了它们的测量特性。29 名参与者（12 名患者）完成了第二次在线调查（回复率 88%），并认可了三种结果测量工具：维多利亚运动评估研究所-跟腱问卷、单腿足跟抬高测试和使用视觉模拟量表评估活动后疼痛（VAS，0-10）。12 名参与者（1 名患者）参加了最终共识会议，并认可了 1 种额外的结果测量工具：使用 VAS （0-10）评估活动/负重期间的疼痛。建议将已确定的 COS-AT 用于未来评估干预有效性的临床试验。这将有助于比较干预策略的结果、数据汇总和有关 AT 的知识的进一步进展。随着 COS-AT 的实施，关于所包含措施的测量特性和新的结果测量工具的进一步证据应导致其审查和完善。

更新日期：2024-10-01

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