Development of psychological and psychosocial core outcome set for tendinopathy research

Tendinopathy is a highly prevalent and often debilitating musculoskeletal condition affecting both athletic and non- athletic populations. Tendinopathy is commonly characterised by persistent tendon pain and loss of function related to mechanical loading. To date, treatment has focussed primarily on the contribution of structural or physical factors and their relationship with outcomes. Tendinopathy is associated with impaired quality of life, reduced sports performance, reduced work ability, and decreased work productivity. Although physiological factors may indeed play a role in persistent musculoskeletal pain conditions, research also points to the strong influence of the dynamic interaction between physiological, psychological and social factors on the persistence of pain and clinical outcome.

To date, there is a wide variation in selected outcome measures used to evaluate psychological and psychosocial factors in tendinopathy studies. The current lack of standardised and valid outcome measures, in tendinopathy studies, has hampered the ability to perform meta-analysis on the efficacy and effectiveness of treatment outcome. The inability to synthesise data has a negative impact on patient care, emphasising the need to define a core outcome set (COS) of standardised and validated psychological and psychosocial outcome measures.

A recent Delphi study conducted in 2019 (ICON 2019), made up of expert tendinopathy clinicians, researchers and patients established nine core health related domains to assess in future tendinopathy clinical trials. One of the core domains identified was psychological factors. Building on the recommendations from ICON 2019, the COS_T_Psych working group have conducted a comprehensive scoping review to identify all psychological and psychosocial outcomes that have been used in tendinopathy research to date.

Leading on from the findings of the scoping review, we aim to develop and disseminate a COS_T_Psych for future tendinopathy research. The COS will be specific to defining a detailed description of psychological and psychosocial outcomes that evaluate the established parent core domain ‘psychological factors’.


Mr Carl Stubbs, Monash University, Victoria, Australia
A/Prof Peter Malliaras, Monash University, Victoria, Australia
Prof Terry Haines, Monash University, Victoria, Australia
Dr Sean Mc Auliffe, Qatar University, Doha, Qatar
Dr Kieran O'Sullivan, University of Limerick, Limerick, Ireland
Dr Melanie Plinsinga, Griffith University, QLD, Australia
Dr Adriam Mallow, University of Essex, Colchester, UK

Further Study Information

Current Stage: Ongoing
Date: January 2021 - December 2021
Funding source(s): No funding

Health Area

Disease Category: Rehabilitation

Disease Name: Tendinopathy

Target Population

Age Range: 18 - 100

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Clinical experts
- Consumers (patients)
- Researchers

Study Type

- COS for clinical trials or clinical research
- COS for practice


- Consensus meeting
- Delphi process
- Literature review
- Survey

Five stage processes including:
(1) Scoping review to extract available data on psychological and psychosocial outcomes measured in tendinopathy studies.
(2) Delphi on-line survey consisting of 3-iterations to determine ‘what’ psychological and psychosocial constructs are important to measure in tendinopathy research. International clinical and research experts in the field of tendinopathy will be invited to participate along with patient representatives who have experienced the condition.
(3) Identify existing outcome measurement instruments for a COS.
(4) Assessing the quality of the measurement properties of OMI’s.
(5) Consensus procedure to agree on the instruments for each outcome included in the COS.