Evidence-based Sports Medicine

Evidence-based Sports Medicineinvestigated. Next, identify the risk factors that are felt to haveappropriate influence on the question/problem, followed by theplanning of the intervention and subsequent evaluation of theoutcome. Too many myths exist. Why are certain treatments/interventions used if they have never been proven to be effective?Current problems in sports injury data collection exist todaybecause many studies are limited by the fact that the data collectionis from the injured athletes alone (case series) or of risk factors alone,which do not allow the use of the epidemiological concept of“athletes being at risk”. Randomisation is difficult but must be workedtowards as it is a key concept. Case series studies are not helpful ininjury prevention but if they are to be used then confoundingvariables, such as previous injuries, must be addressed.Many clinicians, in a position to access data, are not sufficientlytrained in study design and statistical analysis to collect the requiredinformation or put it into a format for publication. Therefore there ismuch information in existence that, frustratingly, is not publishedand cannot be accessed. This is an issue that, if addressed, will takesports epidemiology further. Partnerships can be made with medicalstudents and public health schools to alleviate this problem.Currently there is no common operational definition of sportsinjuries in existence, which constitutes one of the biggest problemsin sports injury data collection. What constitutes an injury in somesports may not be what is considered an injury in another sport.Some studies define an injury as “an incident requiring medical1, 5–7attention following a sport related activity (typical to that sport)”others only define it as an injury “if it requires the athlete to miss therest of that session or a subsequent training or participationsession”. 8,9 The only way forward is to have a set, universal definitionof a sporting injury so that all sports follow one set of guidelines.These guidelines can be a set definition of what constitutes an injury,with a sub-division of definitions (codes) expansive enough toincorporate all sporting diagnoses and subcategories for specificinjury definitions, which can be supplemented for some of theatypical sports.Furthermore, there is no set definition of severity. Some studiesclassify severe injuries as those “requiring five weeks out ofcompetitive competition” others classify severe injuries as those“requiring five games to be missed”. 9,10 The latter is clearly notcompatible if comparing team sports where more than one game isplayed in each week. For example, if a team-player missed three gameswith an ankle sprain and another team-player (examined by the samephysician) missed five games, but both injuries were considered to be14