Methodology used to develop the minimum common data elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement [version 1; peer review: 1 approved, 2 approved with reservations]
Katherine Harrison,
Ben R. Hando,
Alysia Gourlay,
Neil Forrest,
Adam Dooley,
Ben Fisher,
Nigel Arden,
Sarah J. de la Motte,
John J. Fraser,
Joanne L. Fallowfield,
Garrett S. Bullock,
Daniel I. Rhon,
Gary S. Collins,
Carolyn A. Emery,
Richard B. Westrick,
Joshua J. Van Wyngaarden,
Damien Van Tiggelen,
Sandra Williams,
Emma Williams,
Jeffrey M. Tiede,
Deydre S. Teyhen,
Eric Robitaille,
Phillip M. Newman,
Joseph M. Molloy,
Debra Hayhurst
Affiliations
Katherine Harrison
Defense Statistics Health, Ministry of Defence, London, UK
Defence Primary Healthcare, Headquarters Surgeon General, London, UK
Nigel Arden
Centre for Sport, Exercise, and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, UK
Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
Department of Physical Medicine & Rehabilitation, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA
Joanne L. Fallowfield
Institute of Naval Medicine, Directorate of People and Training, Royal Navy, Hampshire, UK
Garrett S. Bullock
Centre for Sport, Exercise, and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, UK
Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, UK
Carolyn A. Emery
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Richard B. Westrick
Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
Joshua J. Van Wyngaarden
Army-Baylor University, Waco, Texas, USA
Damien Van Tiggelen
Belgium Armed Forces, Brussels, Belgium
Sandra Williams
Defence Rehabilitation, Ministry of Defence, London, UK
Emma Williams
Second Health Brigade, Australian Army, Sydney, Australia
Jeffrey M. Tiede
Department of Rehabilitation Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
Deydre S. Teyhen
Defense Health Network, National Capital Region, Defense Health Agency, Bethesda, MD, USA
Eric Robitaille
Teaching Stream Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Background The objective was to summarize the methodology used to reach consensus for recommended minimum data elements that should be collected and reported when conducting injury surveillance research in military settings. This paper summarizes the methodology used to develop the international Minimum Data Elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement. Methods A Delphi methodology was employed to reach consensus for minimum reporting elements. Preliminary steps included conducting a literature review and surveying a convenience sample of military stakeholders to 1) identify barriers and facilitators of military musculoskeletal injury (MSKI) prevention programs, 2) identify relevant knowledge/information gaps and 3) establish future research priorities. The team then led a sequential three-round Delphi consensus survey, including relevant stakeholders from militaries around the world, and then conducted asynchronous mixed knowledge user meeting to explore level of agreement among subject matter experts. Knowledge users, including former and current military service members, civil servant practitioners, and global-wide subject matter experts having experience with policy, execution, or clinical investigation of MSKI mitigation programs, MSKI diagnoses, and MSKI risk factors in military settings. For each round, participants scored each question on a Likert scale of 1-5. Scores ranged from No Importance (1) to Strong Importance (5). Results Literature review and surveys helped informed the scope of potential variables to vote on. Three rounds were necessary to reach minimum consensus. Ninety-five, 65 and 42 respondents participated in the first, second and third rounds of the Delphi consensus, respectively. Ultimately, consensus recommendations emerged consisting of one data principle and 33 minimum data elements. Conclusions Achieving consensus across relevant stakeholders representing military organizations globally can be challenging. This paper details the methodology employed to reach consensus for a core minimum data elements checklist for conducting MSKI research in military settings and improve data harmonization and scalability efforts. These methods can be used as a resource to assist in future consensus endeavors of similar nature.
