38 Chapter 2 CONCLUSION This is the first extensive 5-step process to develop a core outcome set for Achilles tendinopathy (COS-AT). The core outcome set for clinical trials of Achilles tendinopathy consists of 4 outcome measurement instruments that are: 1) the VISA-A questionnaire, 2) the single-leg heel rise test, 3) evaluating pain after activity using a VAS (0 -10) and 4) evaluating pain on activity/loading using a VAS (0-10). Patients and professional participants agreed on these 4 outcome measurement instruments to be part of the COSAT. It is strongly recommended that the selected COS-AT will be used in future clinical trials evaluating effectiveness of an intervention for Achilles tendinopathy, although this does not prevent the use of other outcome measurement instruments. FOOTNOTES Funding The authors from the steering group (RJDV, KS, PM, BV) have not declared a specific grant for this research from any funding agency in the public, commercial or not-forprofit sectors. Within this 5-year project, multiple authors have been supported by specific research fellowships and/or grants that were not directly related to the COS-AT development. One author (DM) mentioned indirect support by the National Institute for Health Research Barts Biomedical Research Centre (NIHR203330). Competing interests None declared. Patient consent for publication Requested and obtained. Ethics approval The medical ethical committee of Erasmus MC University Medical Center confirmed that the Medical Research Involving Human Subjects Act (WMO) did not apply to our study (MEC-2021-0279). Acknowledgements The steering committee would like to acknowledge the contributions to this project of the Achilles tendinopathy Working group, the professional participants and the patients, who donated their time voluntarily. This project would not have been feasible without their help. We would like to acknowledge Peter Stig Magnusson and Jarrod Antflick, who contributed actively during specific phases of this project, but decided to retract their role as co-author.
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