Carnes, Dawn, Mullinger, Brenda and Underwood, M. (Martin) M.D.. (2010) Defining adverse events in manual therapies : a modified Delphi consensus study. Manual Therapy, Vol.15 (No.1). pp. 2-6. ISSN 1356-689X

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Abstract

A pragmatic agreed definition of adverse events in manual therapy is required to explore incidence and prevalence. We aimed to identify and describe such adverse events and seek a consensus definition.

A focus group identified issues surrounding the definition of adverse events and generated the content for a questionnaire. This questionnaire was used to conduct a modified Delphi consensus survey with an expert panel (n=50). Consensus was defined as >74% agreement. Three consensus rounds were executed.

There was a 50% response rate for round one, 62% for round two and 55% for round three. A layered pragmatic definition was agreed:

‘Major’ adverse events are medium to long term, moderate to severe and unacceptable, they normally require further treatment and are serious and distressing;

‘Moderate’ adverse events are as ‘major’ adverse events but only moderate in severity; and

‘Mild’ and ‘not adverse’ adverse events are short term and mild, non-serious, the patient's function remains intact, and they are transient/reversible; no treatment alterations are required because the consequences are short term and contained.

We concluded that classifying adverse events was difficult without context or detail. Classification may be improved by using the taxonomy and descriptions suggested in this study.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology R Medicine > RZ Other systems of medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Delphi method, Manipulation (Therapeutics), Manipulation (Therapeutics) -- Complications, Osteopathic medicine
Journal or Publication Title:	Manual Therapy
Publisher:	Churchill Livingstone
ISSN:	1356-689X
Official Date:	February 2010
Volume:	Vol.15
Number:	No.1
Page Range:	pp. 2-6
Identification Number:	10.1016/j.math.2009.02.003
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	General Osteopathic Council (UK) (GOsC), National Council for Osteopathic Research (NCOR)
URI:	http://wrap.warwick.ac.uk/id/eprint/37496

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