2 23 ICON 2023: Core Outcomes for Achilles Tendinopathy INTRODUCTION Achilles tendinopathy is the clinical diagnosis for load-related pain and disability localized to the Achilles tendon.1 This condition frequently leads to chronic symptoms with poor quality of life and substantial healthcare consumption.2,3 To effectively evaluate recovery of Achilles tendinopathy and treatment effectiveness, reliable and valid outcome measurement instruments are necessary.4-6 Currently, there is considerable variation in the outcome measures used to assess interventions; this can have implications for patient care, as healthcare professionals and researchers are unable to adequately interpret, compare, and synthesize study results in meta-analyses.5,7,8 The importance of developing a Core Outcome Set (COS) for clinical trials is emphasized by both the Outcome Measures in Rheumatology (OMERACT)9 and the Core Outcome Measures in Effectiveness Trials (COMET)10 initiative. These organizations also offer detailed guidelines for the development of a COS.10,11 For inclusion in a COS, outcome measurement instruments must be both feasible (considering cost, patient burden, and availability in the clinical setting) and of sufficient quality (valid, responsive, reliable, and interpretable).9,11 In 2018, a Delphi study was conducted at the International Scientific Tendinopathy Symposium Consensus (ICON) to establish core domains for tendinopathy.7 Expert clinicians and researchers in tendinopathy, as well as patients with tendinopathy at different anatomical sites, identified nine tendinopathy-specific core domains: patient overall rating, participation, pain on activity, disability, function, physical function capacity, quality of life, psychology, and pain over a specified time frame.7 The next step is to use these core domains as a guide to develop core outcome sets for each of the common tendinopathies. A core outcome set for Achilles tendinopathy (COS-AT) is currently lacking. The primary aim is to develop this COS-AT through a systematic search for outcome measurement instruments that map to core tendinopathy domains, methodological quality assessment and a 3-round Delphi including an in-person consensus meeting. After defining the COS-AT, it should be used in future clinical trials evaluating effectiveness of an intervention for Achilles tendinopathy. METHODS Study protocol At the International Scientific Tendinopathy Symposium (ISTS) 2018 an Achilles tendinopathy consensus group was formed.5 This group worked collaboratively on prospective registration of the study protocol on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020156763). The project was also registered in the COMET database (www.comet-initiative.org, reference number 1323).
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