2 31 ICON 2023: Core Outcomes for Achilles Tendinopathy Step 3 – Performing a quality assessment of the endorsed outcome measurement instruments We identified 4,878 potentially relevant publications for assessing the quality of the endorsed outcome measurement instruments in step 3. Figure 1 shows a flowchart of the article selection process. After duplicate removal, 2,119 publications were screened based on the title and abstract. Eight articles were relevant but were excluded because they were not original research articles (e.g. systematic review, scoping review). 42 articles were screened in the full text. 27 articles fulfilled the eligibility criteria and were critically appraised by the methodological experts using the COSMIN criteria.12 A summary of the methodological measurement properties, as also presented to the participants in the 2nd round of the Delphi procedure, was made and is presented in supplementary File 4. There were no available data on the quality of 13/22 (59%) outcome measurement instruments. The remaining 9 outcome measurement instruments showed low quality evidence on their clinimetric properties, with very few studies examining responsiveness, clinical trial discrimination and thresholds of meaning. Moreover, structural validity (when assessed) was not or only partially according to COSMIN guidelines.
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