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This study aimed to establish an inter-professional and international standardized definition and severity classification for AE following MAN and MOB. This sequential mixed-methods study included an electronic Delphi process (e-Delphi) followed by focus groups. Inter-professional and international expert stakeholders participated in 3 e-Delphi rounds: Round 1 included open-ended questions on participants\u2019 working AE definition and severity classification; Round 2, level of agreement with statements generated from Round 1 and a previous scoping review; and Round 3, level of agreement with statements achieving consensus in Round 2. Focus groups explored e-Delphi findings. Consensus was reached for severity categories (i.e., mild, moderate, severe and catastrophic) and on 2 domains to differentiate these categories (i.e., symptom intensity and impact on patient). Consensus was not reached for a standardized AE definition following MAN and MOB. Focus group discussions centered on \u201cunfavourable\u201d, \u201cunexpected\u201d and \u201cundesired\u201d terms and differences between \u201cserious\u201d and \u201ccatastrophic\u201d severity classification categories. Findings contribute to advancing patient safety and AE knowledge across professions and informing further safety research and practice.<\/jats:p>","DOI":"10.1371\/journal.pone.0334151","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:29:22Z","timestamp":1763404162000},"page":"e0334151","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Defining and classifying adverse events following joint manipulation and mobilization: An international e-Delphi study and focus groups"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0292-8668","authenticated-orcid":true,"given":"Martha","family":"Funabashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1937-741X","authenticated-orcid":true,"given":"Lindsay M","family":"Gorrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A","family":"Pohlman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2526-9642","authenticated-orcid":true,"given":"Andrea","family":"Bergna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7599-3674","authenticated-orcid":true,"given":"Nicola R","family":"Heneghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the AdEMMo Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"issue":"5","key":"pone.0334151.ref001","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.jelekin.2012.01.006","article-title":"Epidemiology: Spinal manipulation utilization","volume":"22","author":"EL Hurwitz","year":"2012","journal-title":"J Electromyogr Kinesiol"},{"key":"pone.0334151.ref002","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12998-017-0165-8","article-title":"The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided","volume":"25","author":"PJH Beliveau","year":"2017","journal-title":"Chiropr Man Therap"},{"key":"pone.0334151.ref003","unstructured":"Rushton K, Beeton R, Jordaan JL, Lenerdene L, Lorrie M, Jan Pool A. 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International Classification of Functioning, Disability and Health. International classification of functionin, disability and health: ICF. 2001. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/42407\/9241545429.pdf"},{"key":"pone.0334151.ref026","volume-title":"International Conference on Harmonization Good Clinical Practice. In: Glossary art. 1.2. p","author":"ICH-GCP, (E6)"},{"key":"pone.0334151.ref027","unstructured":"(FDA) F and DA, Coomissioner O of the, (CDER) C for DE and R, (CBER) C for BE and R, (CDRH) C for D and RH, (GCPP) GCPP. Adverse Event Reporting to IRBs \u2014 Improving Human Subject Protection Guidance for Clinical Investigators, Sponsors, and IRBs. 2009. 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Common Terminology Criteria for Adverse Events (CTCAE) v5.0. 2017. p. Published on Novermber 27. https:\/\/doi.org\/10.1039\/DT9930001947","DOI":"10.1039\/DT9930001947"},{"key":"pone.0334151.ref036","article-title":"Chapter 19: Adverse effects.","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"G Preyer","year":"2022"},{"key":"pone.0334151.ref037","unstructured":"World Health Organization. Conceptual Framework for the International Classification for Patient Safety. 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