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

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Bateman, Marcus
Evans, Jonathan P
Vuvan, Viana
Jones, Val
Watts, Adam C
Phadnis, Joideep
Bisset, Leanne M
Vicenzino, Bill
COS-LET Authorship Group
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2022
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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.

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British Journal of Sports Medicine

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© Author(s) (or their employer(s)) 2022. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Biomedical and clinical sciences

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Engineering

Clinical sciences

Sports science and exercise

Applied and developmental psychology

elbow

tendinopathy

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Bateman, M; Evans, JP; Vuvan, V; Jones, V; Watts, AC; Phadnis, J; Bisset, LM; Vicenzino, B; COS-LET Authorship Group, , Development of a core outcome set for lateral elbow tendinopathy (COS-LET) using best available evidence and an international consensus process, British Journal of Sports Medicine, 2022

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