scholarly journals Consensus meetings and statements are flawed by design: A narrative review with suggestions for improvements

2020 ◽  
Author(s):  
Ian Shrier
Keyword(s):  
Sport Injury ◽  
Narrative Review ◽  
Consensus Methods ◽  
Supreme Courts ◽  
Surveillance Studies ◽  
Exercise Medicine ◽  
Consensus Statements ◽  
Recent Statement ◽  
Sport And Exercise ◽  
Medicine Community

Consensus statements from the sport and exercise medicine community are now fairly common. More recently, the statements appear more prescriptive, strongly recommending particular approaches to research or treatment. The most recent statement on methods for reporting sport injury surveillance studies included an extension to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) reporting guidelines; STROBE guidelines are now official requirements for many journals. This suggests that investigators who use methods outside of these guidelines may have difficulty publishing their results. The challenge is that by definition, consensus is not unanimity. Therefore, consensus recommendations are sometimes considered flawed at a later date. This is expected if we gain new knowledge. However, the consensus methods themselves may also inadvertently lead to a suppression of contrary but valid opinions. The purpose of this narrative review it to propose a different model for consensus meetings and statements that embraces dissenting opinions, leading to increased transparency. In brief, the method is based on how Supreme Courts functions, allowing for both majority and one or more minority opinions. I illustrate how a consensus statement might be written using examples from four previous sport and exercise medicine consensus statements between 2005 and 2020. Such an approach will help ensure that clinicians, researchers and journals are not inappropriately influenced by recommendations from consensus statements, where experts continue to have important disagreements about the strength and interpretation of the evidence.

Consensus statements that fail to recognise dissent are flawed by design: a narrative review with 10 suggested improvements

2020 ◽  
pp. bjsports-2020-102545
Author(s):  
Ian Shrier
Keyword(s):  
Supreme Court ◽  
Sport Injury ◽  
Consensus Statement ◽  
Consensus Methods ◽  
Supreme Courts ◽  
Surveillance Studies ◽  
Exercise Medicine ◽  
Consensus Statements ◽  
The Supreme Court ◽  
Sport And Exercise

Consensus statements have the potential to be very influential. Recently, such statements in sport and exercise medicine appear more prescriptive, strongly recommending particular approaches to research or treatment. In 2020, a statement on methods for reporting sport injury surveillance studies included an extension to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines; STROBE guidelines are now official requirements for many journals. This suggests that investigators who use methods outside of these guidelines may have difficulty publishing their results. By definition, consensus is not unanimity, and consensus recommendations are sometimes considered flawed at a later date. This is expected as a discipline benefits from new knowledge. However, the consensus methods themselves may also inadvertently suppress contrary—but valid—opinions. I point to a different model for consensus meetings and statements that embraces dissenting opinions and is more transparent than common current methods in sport and exercise medicine. The method, based on how Supreme Courts function in many countries, allows for both majority and one or more minority opinions. I illustrate how a consensus statement might be written using examples from four previous sport and exercise medicine consensus statements. By adopting the ‘Supreme Court’ approach, important disagreements about the strength and interpretation of evidence will be far more visible than is currently the case in most consensus meetings. The benefit of the Supreme Court model is that it will ensure that clinicians, researchers and journals are not inappropriately influenced by recommendations from consensus statements where uncertainty remains.

scholarly journals Remote assessment in sport and exercise medicine (SEM): a narrative review and teleSEM solutions for and beyond the COVID-19 pandemic

2020 ◽  
Vol 54 (19) ◽  
pp. 1162-1167 ◽  
Author(s):  
H Paul Dijkstra ◽  
Emin Ergen ◽  
Louis Holtzhausen ◽  
Ian Beasley ◽  
Juan Manuel Alonso ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Care ◽  
Narrative Review ◽  
Review Of The Literature ◽  
Exercise Medicine ◽  
Remote Assessment ◽  
Injury Assessment ◽  
Guiding Principles ◽  
Sport And Exercise ◽  
Remote Patient

BackgroundThe COVID-19 pandemic forces sport and exercise medicine (SEM) physicians to think differently about the clinical care of patients. Many rapidly implement eHealth and telemedicine solutions specific to SEM without guidance on how best to provide these services.AimThe aim of this paper is to present some guiding principles on how to plan for and perform an SEM consultation remotely (teleSEM) based on a narrative review of the literature. A secondary aim is to develop a generic teleSEM injury template.ResultseHealth and telemedicine are essential solutions to effective remote patient care, also in SEM. This paper provides guidance for wise planning and delivery of teleSEM. It is crucial for SEM physicians, technology providers and organisations to codesign teleSEM services, ideally involving athletes, coaches and other clinicians involved in the clinical care of athletes, and to gradually implement these services with appropriate support and education.ConclusionteleSEM provides solutions for remote athlete clinical care during and after the COVID-19 pandemic. We define two new terms—eSEM and teleSEM and discuss guiding principles on how to plan for and perform SEM consultations remotely (teleSEM). We provide an example of a generic teleSEM injury assessment guide.

scholarly journals Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study

2020 ◽  
Vol 6 (1) ◽  
pp. e000888
Author(s):  
Dane Vishnubala ◽  
Katherine Rose Marino ◽  
Margaret Kathryn Pratten ◽  
Andy Pringle ◽  
Steffan Arthur Griffin ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Thematic Analysis ◽  
Heavy Exercise ◽  
Structured Interviews ◽  
Ultrasound Education ◽  
Exercise Medicine ◽  
Sport And Exercise ◽  
Inductive Thematic Analysis

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

PRP use in sport and exercise medicine: be wary of science becoming the sham

2021 ◽  
pp. bjsports-2021-104822
Author(s):  
Jon Patricios ◽  
Kimberly G Harmon ◽  
Jonathan Drezner
Keyword(s):  
Exercise Medicine ◽  
Sport And Exercise

scholarly journals Special Issue “New Trends in Sport and Exercise Medicine”

2021 ◽  
Vol 11 (18) ◽  
pp. 8353
Author(s):  
Daniela Galli
Keyword(s):  
Physical Activity ◽  
Cardiovascular Diseases ◽  
Regular Physical Activity ◽  
Special Issue ◽  
Exercise Medicine ◽  
Sport And Exercise

The practice of regular physical activity has been proposed as a determinant in many disciplines, from wellness to physiotherapy; in fact, it reduces the risks of cardiovascular diseases and diabetes [...]

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