2 35 ICON 2023: Core Outcomes for Achilles Tendinopathy It also became clear that high quality studies into all different clinimetric properties of the outcome measures are lacking. Only moderate evidence was available for some outcome measurement instruments. Especially on construct validity – with inclusion of structural validity and cross-cultural adaptation, which are not assessed in the current study following OMERACT guidelines – and responsiveness, clinical trial discrimination and thresholds of meaning more research is needed. Clinical and research implications The development of the COS-AT carries significant clinical and research implications. The introduction of standardized outcome measurement instruments, as derived in this study, offers several potential benefits. The COS-AT will enhance the ability to conduct meaningful meta-analyses in the future, providing a more robust foundation for advancing our understanding of interventions for Achilles tendinopathy. The adequate evaluation and comparison of interventions will facilitate evidence-based decision making for professional participants in the future. This could lead to more effective and personalized treatment strategies, ultimately improving patient care and outcomes. It is strongly recommended that the selected COS-AT will be used in future research, although this does not preclude the use of other outcome measurement instruments. For example, if an intervention is aimed to improve or evaluate psychosocial factors in Achilles tendinopathy patients it is still appropriate to include an outcome measurement instrument that covers this specific domain (along with the COS-AT). It is crucial to recognize that the implementation of the COS-AT may face certain barriers. Researchers and clinicians accustomed to using a variety of outcome measurement instruments may require time to adapt to this standardized approach.17,18 Lack of awareness and familiarity of the recommended COS-AT could also potentially form a barrier to effective implementation.19 Another barrier might be that other more general healthrelated outcome measurement instruments are considered important in specific clinical settings. Adding disease-specific outcome measurement instruments to this set might not be feasible. To facilitate effective implementation of the COS-AT, researchers and clinicians need to be informed about the benefits of the COS-AT and why they are relevant to patients.18 Another facilitator of implementation of the COS-AT is the use of an international panel with both professional participants and patients in the consensus process.17,18 It should be noted that the exclusion of some outcome measurement instruments from the COS-AT, such as pain on tendon palpation or assessment of psychosocial factors, does not diminish their relevance. These measures are still regarded to be important in the evaluation and management of Achilles tendinopathy.
RkJQdWJsaXNoZXIy MTk4NDMw