Downloaded from http://bjsm.bmj.com/ on June 3, 2015 - Published by group.bmj.com
Editorial
Thousand mile journey ( part II): collaborative steps to advance the management of groin pain in athletes
with groin pain. We think we have taken another step in the right direction! Competing interests None declared. Provenance and peer review Commissioned; internally peer reviewed.
Adam Weir Last year I wrote an editorial, “From disruption to consensus: the thousand mile journey”,1 to accompany the British Hernia Society’s position statement on the treatment of sportsman’s groin.2 This was the first time a consensus approach had been trialled in the field of groin pain in athletes. Since this first step on the long journey to improve outcomes for athletes with groin pain, the field has advanced further. The first World Conference on Groin Pain in Athletes was held in Doha, Qatar, in November 2014. After the conference, the “Doha Agreement Meeting on Terminology and Definitions in Groin Pain in Athletes” was held in Aspetar Hospital.
AGREE TO DISAGREE EB White stated that “there is nothing more likely to start disagreement… than agreement”. The challenge of bringing together 24 experts from different disciplines and continents was a fairly daunting one. But now, after having gone through the process of agreeing, I would have to disagree. Our aim was to try to agree on a standard terminology with accompanying definitions. Open discussions, professional respect and a general sense of having a common goal, made for an agreeable atmosphere. Unanimous agreement was achieved and we are proud to present the results in this issue.3
THE NEXT STEP Agreeing on terminology and definitions is an important advance in the field. Until now, heterogeneous taxonomy has hampered communication among clinicians and made comparing study results virtually impossible. By bringing together clinicians and researchers, from different disciplines and continents, we hope our wide reach will facilitate that implementation. The paper is open access and I hope you will Correspondence to Dr Adam Weir, Aspetar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar; [email protected]
read and implement it into your practice, allowing us, ‘the sports medicine community’, to speak a common language.
STEP ON IT! Nine reviews accompany the new agreement article and eight are presented in this issue.4–12 These summarise the state of affairs across many of the topics surrounding groin pain in athletes. The treatment review includes 72 clinical studies on groin pain in athletes.11 Only four studies were of high quality, and the ‘Coleman’ effect, where weaker methodology in studies was associated with better reported outcomes,1 was confirmed. This highlights the need for higher quality studies in the future. A homogenous taxonomy with clear definitions is one step to achieving this. The next step to further facilitate clinicians and researchers in the field was developing ‘minimal reporting standards’.13 This paper contains practical advice on designing research aimed to help improve the quality. In this way we hope to add to the momentum of the Agreement meeting by facilitating those planning new projects or writing up older ones.
STEPPING STONES I am proud to have been part of this project and hope that it will represent a stepping stone to help us bridge the gap between research and clinical practice. My thanks to all 23 colleagues who contributed to the Doha Agreement and to the 300 who contributed to the vibrant conference at the Aspire Zone, Doha. Scientific advances are created by collaborative teams. The wish of all involved is that this BJSM issue captures that collaboration. Please click through to the summaries of the current evidence, the call for a common terminology with definitions, and suggestions to improve the quality or research design and reporting. The aim? Improved outcomes when athletes present
Weir A. Br J Sports Med June 2015 Vol 49 No 12
To cite Weir A. Br J Sports Med 2015;49:763. Accepted 21 April 2015 Br J Sports Med 2015;49:763. doi:10.1136/bjsports-2015-094907
REFERENCES 1 2
3
4
5
6
7
8
9
10
11
12
13
Weir A. From disruption to consensus: the thousand mile journey. Br J Sports Med 2014;48:1075–7. Sheen AJ, Stephenson BM, Lloyd DM, et al. ‘Treatment of the sportsman’s groin’: British Hernia Society’s 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med 2014;48:1079–87. Weir A, Hölmich P, Schache AG, et al. Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method. Br J Sports Med 2015;49:825–7. Esteve E, Rathleff MS, Bagur-Calafat C, et al. Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med 2015;49:785–91. Waldén M, Hägglund M, Ekstrand J. The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med 2015;49:792–7. Orchard JW. Men at higher risk of groin injuries in elite team sports: a systematic review. Br J Sports Med 2015;49:798–802. Whittaker JL, Small C, Maffey L, et al. Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med 2015;49:803–809. Mosler AB, Agricola R, Weir A, et al. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 2015;49:810. Reiman MP, Goode AP, Cook CE, et al. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. Br J Sports Med 2015;49:811. Thorborg K, Tijssen M, Habets B, et al. Patient-Reported Outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence. Br J Sports Med 2015;49:812. Serner A, van Eijck CH, Beumer BR, et al. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015;49:813. Casartelli NC, Leunig M, Maffiuletti NA, et al. Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med 2015;49:819–24. Delahunt E, Thorborg K, Khan KM, et al. Minimum reporting standards for clinical research on groin pain in athletes. Br J Sports Med 2015;49:775–81.
763
Downloaded from http://bjsm.bmj.com/ on June 3, 2015 - Published by group.bmj.com
Thousand mile journey (part II): collaborative steps to advance the management of groin pain in athletes Adam Weir Br J Sports Med 2015 49: 763
doi: 10.1136/bjsports-2015-094907 Updated information and services can be found at: http://bjsm.bmj.com/content/49/12/763
These include:
References Email alerting service
This article cites 12 articles, 12 of which you can access for free at: http://bjsm.bmj.com/content/49/12/763#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Editorial
Thousand mile journey ( part II): collaborative steps to advance the management of groin pain in athletes
with groin pain. We think we have taken another step in the right direction! Competing interests None declared. Provenance and peer review Commissioned; internally peer reviewed.
Adam Weir Last year I wrote an editorial, “From disruption to consensus: the thousand mile journey”,1 to accompany the British Hernia Society’s position statement on the treatment of sportsman’s groin.2 This was the first time a consensus approach had been trialled in the field of groin pain in athletes. Since this first step on the long journey to improve outcomes for athletes with groin pain, the field has advanced further. The first World Conference on Groin Pain in Athletes was held in Doha, Qatar, in November 2014. After the conference, the “Doha Agreement Meeting on Terminology and Definitions in Groin Pain in Athletes” was held in Aspetar Hospital.
AGREE TO DISAGREE EB White stated that “there is nothing more likely to start disagreement… than agreement”. The challenge of bringing together 24 experts from different disciplines and continents was a fairly daunting one. But now, after having gone through the process of agreeing, I would have to disagree. Our aim was to try to agree on a standard terminology with accompanying definitions. Open discussions, professional respect and a general sense of having a common goal, made for an agreeable atmosphere. Unanimous agreement was achieved and we are proud to present the results in this issue.3
THE NEXT STEP Agreeing on terminology and definitions is an important advance in the field. Until now, heterogeneous taxonomy has hampered communication among clinicians and made comparing study results virtually impossible. By bringing together clinicians and researchers, from different disciplines and continents, we hope our wide reach will facilitate that implementation. The paper is open access and I hope you will Correspondence to Dr Adam Weir, Aspetar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar; [email protected]
read and implement it into your practice, allowing us, ‘the sports medicine community’, to speak a common language.
STEP ON IT! Nine reviews accompany the new agreement article and eight are presented in this issue.4–12 These summarise the state of affairs across many of the topics surrounding groin pain in athletes. The treatment review includes 72 clinical studies on groin pain in athletes.11 Only four studies were of high quality, and the ‘Coleman’ effect, where weaker methodology in studies was associated with better reported outcomes,1 was confirmed. This highlights the need for higher quality studies in the future. A homogenous taxonomy with clear definitions is one step to achieving this. The next step to further facilitate clinicians and researchers in the field was developing ‘minimal reporting standards’.13 This paper contains practical advice on designing research aimed to help improve the quality. In this way we hope to add to the momentum of the Agreement meeting by facilitating those planning new projects or writing up older ones.
STEPPING STONES I am proud to have been part of this project and hope that it will represent a stepping stone to help us bridge the gap between research and clinical practice. My thanks to all 23 colleagues who contributed to the Doha Agreement and to the 300 who contributed to the vibrant conference at the Aspire Zone, Doha. Scientific advances are created by collaborative teams. The wish of all involved is that this BJSM issue captures that collaboration. Please click through to the summaries of the current evidence, the call for a common terminology with definitions, and suggestions to improve the quality or research design and reporting. The aim? Improved outcomes when athletes present
Weir A. Br J Sports Med June 2015 Vol 49 No 12
To cite Weir A. Br J Sports Med 2015;49:763. Accepted 21 April 2015 Br J Sports Med 2015;49:763. doi:10.1136/bjsports-2015-094907
REFERENCES 1 2
3
4
5
6
7
8
9
10
11
12
13
Weir A. From disruption to consensus: the thousand mile journey. Br J Sports Med 2014;48:1075–7. Sheen AJ, Stephenson BM, Lloyd DM, et al. ‘Treatment of the sportsman’s groin’: British Hernia Society’s 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med 2014;48:1079–87. Weir A, Hölmich P, Schache AG, et al. Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method. Br J Sports Med 2015;49:825–7. Esteve E, Rathleff MS, Bagur-Calafat C, et al. Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med 2015;49:785–91. Waldén M, Hägglund M, Ekstrand J. The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med 2015;49:792–7. Orchard JW. Men at higher risk of groin injuries in elite team sports: a systematic review. Br J Sports Med 2015;49:798–802. Whittaker JL, Small C, Maffey L, et al. Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med 2015;49:803–809. Mosler AB, Agricola R, Weir A, et al. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 2015;49:810. Reiman MP, Goode AP, Cook CE, et al. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. Br J Sports Med 2015;49:811. Thorborg K, Tijssen M, Habets B, et al. Patient-Reported Outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence. Br J Sports Med 2015;49:812. Serner A, van Eijck CH, Beumer BR, et al. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015;49:813. Casartelli NC, Leunig M, Maffiuletti NA, et al. Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med 2015;49:819–24. Delahunt E, Thorborg K, Khan KM, et al. Minimum reporting standards for clinical research on groin pain in athletes. Br J Sports Med 2015;49:775–81.
763
Downloaded from http://bjsm.bmj.com/ on June 3, 2015 - Published by group.bmj.com
Thousand mile journey (part II): collaborative steps to advance the management of groin pain in athletes Adam Weir Br J Sports Med 2015 49: 763
doi: 10.1136/bjsports-2015-094907 Updated information and services can be found at: http://bjsm.bmj.com/content/49/12/763
These include:
References Email alerting service
This article cites 12 articles, 12 of which you can access for free at: http://bjsm.bmj.com/content/49/12/763#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
