{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:00:04Z","timestamp":1792130404518,"version":"4.4.0"},"reference-count":38,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000276","name":"UK Department of Health","doi-asserted-by":"crossref","award":["NIHR302104"],"award-info":[{"award-number":["NIHR302104"]}],"id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,3]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>(1) To develop an intervention for to support patients diagnosed with an anterior cruciate ligament (ACL) rupture with decision-making regarding treatment. (2) To define evidence-based recommendations for the treatment of patients following an ACL rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nominal group technique consensus study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online meetings with patients and key stakeholders working and receiving treatment in the National Health Service, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Consensus meetings composed of eight voting participants and five non-voting facilitators. Voting participants included five clinicians, one outpatient therapy manager and two patients with experience in an ACL rupture and reconstructive surgery. Non-voting facilitators supported group discussions and\/or observed study procedures. This included a clinical academic expert, two methodology experts and two patient representatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Two online meetings were held. Pre-elicitation material was distributed ahead of the first meeting. Premeeting voting was conducted ahead of both meetings. A draft of the shared decision-making intervention and recommendations were shared ahead of the second meeting. Components were discussed and ranked for inclusion based on a 70% agreement threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The meetings led to the development of a shared decision-making intervention to support treatment decision-making following an ACL rupture. The intervention includes two components: (1) a patient information leaflet and key questions diagram and (2) option grid. The evidence-based recommendations encompass core components of treatment reaching the 70% threshold agreed by the group. The recommendations cover: (1) advice and education, (2) exercise guidance, (3) intervention delivery, (4) outcome measure use and (5) shared decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study has successfully developed a shared decision-making intervention to support ACL treatment decision-making, ready for testing in a future feasibility study. Evidence-based recommendations for the treatment of patients following ACL injury, ready for testing in a National Health Service (UK) setting, are also presented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05529511\">NCT05529511<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082387","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T23:05:40Z","timestamp":1721343940000},"page":"e082387","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Development of an intervention for patients following an anterior cruciate ligament rupture: an online nominal group technique consensus study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05529511","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0837-0802","authenticated-orcid":false,"given":"Hayley","family":"Carter","sequence":"first","affiliation":[{"name":"Physiotherapy Outpatients, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK"},{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-6389","authenticated-orcid":false,"given":"David","family":"Beard","sequence":"additional","affiliation":[{"name":"Surgical Intervention Trials Unit, Botnar Research Centre, NDORMS, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Leighton","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Moffatt","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4723-0028","authenticated-orcid":false,"given":"Benjamin E","family":"Smith","sequence":"additional","affiliation":[{"name":"Physiotherapy Outpatients, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK"},{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate E","family":"Webster","sequence":"additional","affiliation":[{"name":"School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillipa","family":"Logan","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"2025121300254544000_14.7.e082387.1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1080\/15438627.2012.680633","article-title":"Systematic review: annual incidence of ACL injury and surgery in various populations","volume":"20","author":"Moses","year":"2012","journal-title":"Res Sports Med"},{"key":"2025121300254544000_14.7.e082387.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01424-6"},{"key":"2025121300254544000_14.7.e082387.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n375","article-title":"Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial","volume":"372","author":"Reijman","year":"2021","journal-title":"BMJ"},{"key":"2025121300254544000_14.7.e082387.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907797"},{"key":"2025121300254544000_14.7.e082387.5","unstructured":"NHS England and NHS Improvement . 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