Proud to have collaborated with good friend and colleague Rasmus Nielsen on this one. A statement on Methods in Sport Injury Research which was written based on the discussions at the First METHODS MATTER Meeting in Copenhagen in 2019.
High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods—methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting:
There is no need for a single, universally accepted definition of sport injury
Choosing an injury definition is a balancing act between a range of factors, such as level of pain/injury severity, number of cases, research question, and ease of reporting. As these factors are often competing, we encourage researchers to match their choice of definition to the study purpose, setting, and design
Be explicit about the research goal (eg, description, prediction, or causal inference)
To ensure that sports injury researchers report the goal of their research in their publications, we recommend coordinated action by sports science and medicine journals. For instance, the author guidelines could state that authors should explicitly describe their research goal
Define the terms used in research (eg, prediction, causation). Standard language that clinicians and researchers understand will improve evidence transparency and quality
Clearly outline your assumptions. Specifying your theoretical framework and/or drawing a causal diagram when dealing with a causal ques- tion is generally very helpful to the reader
As sports injury occurrence is likely a highly dynamic process, investigating changes over time is important. Consequently, sports injury researchers are recommended to embrace the options that longitudinal data offer
The choice of the statistical analytical approach depends on various factors, including, but not limited to, research question, injury measure (eg, prevalence, incidence), type of injury data (categorical or numerical/continuous), and study design
There is no consensus on what constitutes a “healed” injury
There is no consensus on the recommended statistical approach to analyze recurrent injury data, subsequent injury data, or data on injury exacerbation
As no consensus on what constitutes a recurrent injury, subsequent injury, or injury exacerbation should exist, classifications of recurrent injury, subsequent injury, and injury exacerbation should be clearly defined in each manuscript
Researchers require at least a basic understanding of what complex systems entail and how to interpret the results to better use complex system analysis in sports science
Statistical modeling and systems-based modeling approaches that recognize nonlinear complex interactions complement traditional biostatistical and epidemiological methods.
Approaches that combine qualitative and quantitative methods may help investigators better understand how nonlinear complex interactions underpin most sports injuries
Collaboration bridges gaps between statisticians, epidemiologists, sports injury researchers, athletes, and clinical experts
Involve statisticians, epidemiologists, and practitioners early when designing a study, not after data have been collected
Working in diverse, multidisciplinary teams should help to better formulate research questions, identify an appropriate study design, ensure appropriate and legally acceptable data acquisition, conduct correct statistical analyses, make proper interpretation of study results, and disseminate them in suitable implementation contexts
Stakeholders in sports injury research are encouraged to intensify their investments in statistical, epidemiological, and methodological education in our field, such as multisite and interdisciplinary collaborations, training reviewers, providing online opportunities, exchanging trainees, developing (and extending) guidelines, and including methods content in regular scientific meetings
Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts.
This article has been co-published in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy.
Nielsen RO, Shrier I, Casals M, et al. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876
Nielsen RO, Shrier I, Casals M, et al. Br J Sports Med Epub ahead of print. doi:10.1136/ bjsports-2019-101323