Who Counted as an Expert and Whose Expertise Counted in Consensus Statements on Patellofemoral Pain or Patellofemoral Osteoarthritis?

Introduction: Consensus recommendations bridge knowledge gaps in patellofemoral pain (PFP) research and/or clinical practice. The prevalence of PFP is 29% in elite, and 23% in amateur, female athletes.1 Consensus recommendations depend on the expertise of panelists who take part in the consensus process. To represent their target population, panels should include persons impacted by their work.2 Objectives: To assess who has been invited and whose opinions have counted towards consensus recommendations on PFP or Patellofemoral osteoarthritis (PF-OA). Study Design: A secondary analysis of data from a scoping review. Methods: The Joanna Briggs Institute Manual for Evidence Synthesis was used to map consensus statements in PFP and PF-OA. Two reviewers extracted data on the panelists including: number of panelists; definition of expertise; sex; country; country income level; and the reason they were invited to participate. Population: PFP 'experts'. Inclusion criteria -- had to be a panelist in a consensus statement making recommendations on PFP. Results: Twenty-two consensus statements were included. Thirteen (59%) focused on treatment recommendations. Nine (39%) provided a justification for why panelists were invited. Sixteen (73%) reported panelist numbers (N=365). Eleven (50%) reported panelist sex; 66% of panelists were male (111 of 169). Twelve (55%) reported panelist country; 44% (117 of 263) of panelists represented the USA or Canada. All panels included either a medical doctor or physical therapist. One consensus panel included a patient. Conclusions: PFP and PF-OA consensus statements have often failed to define who counts as an expert and the panels have lacked diversity. Experience--the metric most often used to identify experts--is not a perfect proxy for expertise.3 The patient/athlete voice has been missing from consensus panels, meaning that recommendations may not serve the athletic population who are affected by PFP. [ABSTRACT FROM AUTHOR]

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