Development of a core outcome set for lateral elbow tendinopathy (COS-LET) using best available evidence and an international consensus process

Bateman, Marcus; P. Evans, Jonathan; Vuvan, Viana; Jones, Val; C. Watts, Adam; Phadnis, Joideep; M. Bisset, Leanne; Vicenzino, Bill; Andia, Isabel; Arrigoni, Paolo; Aydin, Canan; Barratt, Paul; Chidambaram, Ram; Cleland, Joshua; Coombes, Brooke; Farkash, Uri; Gosens, Taco; Heales, Luke; Kroslak, Martin; Littlewood, Chris; MacDermid, Joy; Murrell, George; Olaussen, Morten; Orchard, John; Pienimaki, Tuomo; Rangan, Amar; Solheim, Eirik; Stasinopoulos, Dimitrios; Thomas, Jill; Tyler, Timothy; Van Der Windt, Danielle; Van Riet, Roger; Wang, Allan; Waugh, Esther; Moriatis Wolf, Jennifer; Wright, Tony; Zeisig, Eva; Hao Zheng, Ming; Mistry, Priyesh; Newsome, Ruth; Ford, Mark; Jackson, Karen; Le, Phuong; Yeun Song, Joo

Abstract

Objectives: To develop a core outcome set for lateral elbow tendinopathy (COS-LET) and to provide guidance for outcome evaluation in future studies.

Methods: We implemented a multi-stage mixed-methods design combining two systematic reviews, domain mapping of outcome measurement instruments to the core domains of tendinopathy, psychometric analysis of instruments, two patient focus groups and a Delphi study incorporating two surveys and an international consensus meeting. Following the OMERACT guidelines, we used a 70% threshold for consensus.

Results: 38 clinicians/researchers and 9 patients participated. 60 instruments were assessed for inclusion. The only instrument that was recommended for the COS-LET was Patient Rated Tennis Elbow Evaluation (PRTEE) for the disability domain. Interim recommendations were made to use: the PRTEE function subscale for the function domain; PRTEE pain subscale items 1, 4 and 5 for the pain over a specified time domain; pain-free grip strength for the physical function capacity domain; a Numerical Rating Scale measuring pain on gripping for the pain on activity/loading domain; and time off work for the participation in life activities domain. No recommendations could be made for the quality-of-life, patient rating of condition and psychological factors domains.

Conclusions: The COS-LET comprises the PRTEE for the disability domain. Interim-use recommendations included PRTEE subscales, time off work, pain-free grip strength and a Numerical Rating Scale measuring pain on gripping. Further work is required to validate these interim measures and develop suitable measures to capture the other domains.

• Journal Article Type: Article
• Acceptance Date: Jan 14, 2022
• Online Publication Date: Feb 8, 2022
• Publication Date: Jun 1, 2022
• Deposit Date: Nov 19, 2024
• Publicly Available Date: Nov 22, 2024
• Journal: British journal of sports medicine
• Print ISSN: 0306-3674
• Electronic ISSN: 1473-0480
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 56
• Issue: 12
• Pages: 657-666
• DOI: https://doi.org/10.1136/bjsports-2021-105044
• PMID: 35135827