Author Reply to “Regarding ‘Subacromial Decompression in Patients With Shoulder Impingement With an Intact Rotator Cuff: An Expert Consensus Statement Using the Modified Delphi Technique Comparing North American to European Shoulder Surgeons’”

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin; Shea, Kevin P.

doi:10.1016/j.arthro.2022.06.012

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Therefore, it seems fair to conclude that SAPS is a clinical diagnosis characterised by subacromial pain with the absence of other shoulder pathology. This perspective is in line with a recent consensus paper from shoulder experts in North America and Europe 15. However, despite this general view, a large variation in diagnostic criteria was seen across the included studies.…”

Section: Discussionsupporting

confidence: 86%

Terminology and diagnostic criteria used in studies investigating patients with subacromial pain syndrome from 1972 to 2019: a scoping review

et al. 2023

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IntroductionThere is no recognised terminology, nor diagnostic criteria, for patients with subacromial pain syndrome (SAPS). This is likely to cause heterogeneity across patient populations. This could be a driver of misconceptions and misinterpretations of scientific results. We aimed to map the literature regarding terminology and diagnostic criteria used in studies investigating SAPS.Materials and methodsElectronic databases were searched from inception to June 2020. Original peer-reviewed studies investigating SAPS (also known as subacromial impingement or rotator cuff tendinopathy/impingement/syndrome) were eligible for inclusion. Studies containing secondary analyses, reviews, pilot studies and studies with less than 10 participants were excluded.Results11 056 records were identified. 902 were retrieved for full-text screening. 535 were included. 27 unique terms were identified. Mechanistic terms containing ‘impingement’ are used less than before, while SAPS is used increasingly. For diagnoses, combinations of Hawkin’s, Neer’s, Jobe’s, painful arc, injection test and isometric shoulder strength tests were the most often used, though this varied considerably across studies. 146 different test combinations were identified. 9% of the studies included patients with full-thickness supraspinatus tears and 46% did not.ConclusionThe terminology varied considerably across studies and time. The diagnostic criteria were often based on a cluster of physical examination tests. Imaging was primarily used to exclude other pathologies but was not used consistently. Patients with full-thickness supraspinatus tears were most often excluded. In summary, studies investigating SAPS are heterogeneous to an extent that makes it difficult, and often impossible, to compare studies.

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Section: Discussionsupporting

confidence: 86%

Terminology and diagnostic criteria used in studies investigating patients with subacromial pain syndrome from 1972 to 2019: a scoping review

et al. 2023

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“…The modi ed Delphi approach is valuable for exploring clinical decision-making, especially when traditional methods like randomised clinical trials (RCTs) are impractical due to the complex nature of clinical practice (20). It is widely used in clinical settings to identify problems, establish practice guidelines, and develop quality standards (21). Expert opinions are sought systematically and anonymously in the modi ed Delphi, facilitating the identi cation of decision-making factors, prioritisation of interventions, and development of consensus-based guidelines (22,23) that can inform patient care.…”

Section: Introductionmentioning

confidence: 99%

Osteopathic management of non-specific neck pain: a modified Delphi study

Fleischmann,

McLaughlin,

Vaughan

et al. 2024

Preprint

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Background Neck pain is a widespread and persistent musculoskeletal condition, with over half of cases unresolved for years. Nonspecific neck pain poses a particular challenge, often driven by complex physical, psychological, and social factors that lead to ongoing disability. Osteopaths frequently treat musculoskeletal pain using a biopsychosocial approach, yet their specific strategies for nonspecific neck pain remain largely unexplored and likely vary based on practitioner approach. Methods Eleven osteopaths took part in a modified Delphi involving the completion of successive online questionnaires. Across three distinct rounds, participants responded to three different questionnaires distributed via email. Survey development was based on HOAC-II, a patient centred framework for healthcare. Surveys comprised questions related to frequency of use of various osteopathic examination, treatment and management techniques and strategies for patients with nonspecific neck pain. Round 1 and Round 2 comprised open ended questions, Round 3 sought an agreement (Kendall’s W) from panel members about what examination, treatment techniques and management approaches are essential for patients with nonspecific neck pain. Results This modified Delphi study established a consensus among expert osteopaths regarding the examination and management of patients with NSNP. Employing the patient-centred HOAC-II framework, the study highlighted key elements of NSNP care deemed essential by Australian osteopaths. Conclusion The study revealed that the examination techniques and management strategies osteopaths consider essential for patients with non-specific neck pain align with practices frequently used by other health professionals.

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