{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:08:28Z","timestamp":1788977308961,"version":"build-2803163510"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["#NSTC 113-2410-H-037-025-"],"award-info":[{"award-number":["#NSTC 113-2410-H-037-025-"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Sun Yat-sen University and Kaohsiung Medical University Joint Research Project","award":["NSYSUKMU 113-I01"],"award-info":[{"award-number":["NSYSUKMU 113-I01"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Because lumbopelvic\u2013hip (LPH) dysfunction in athletes is commonly associated with subsequent low back pain (LBP), this cross-sectional derivation and internal validation study aimed to develop and internally validate a clinical triage scoring system (CTSS) for field-based identification of collegiate athletes requiring priority intervention-namely, those who, in the judgment of experts, are likely to warrant further assessment and management. A total of 864 collegiate athletes (mean age 21.3\u2009\u00b1\u20092.4 years; 80.8% male) were recruited from 10 universities. Participants underwent standardized assessments including demographic characteristics, clinical history, and LPH functional testing. Using an expert-adjudicated binary reference standard (priority intervention vs self-management), a multivariable logistic regression model was developed to derive the weighted CTSS. Model performance was evaluated using discrimination, calibration, and decision curve analysis (DCA), and internal validation was performed using 1,000 bootstrap resamples. Of the 864 participants, 463 athletes (53.6%) were classified as requiring priority clinical assessment. The final 14-factor CTSS comprised 12 positive-weight predictors, such as localized LPH pain, muscle weakness, and higher body mass index, and 2 negative-weight predictors, positive Lasegue\u2019s sign and hamstring weakness, which functioned as safety-related modifiers. The model demonstrated acceptable discrimination (AUROC\u2009=\u20090.851, 95% CI: 0.824\u20130.876), with minimal optimism (optimism-corrected AUROC\u2009=\u20090.842) and excellent calibration (calibration slope\u2009=\u20090.996; calibration intercept\u2009=\u20090.0003). A total score of \u22659 was identified as the optimal threshold, yielding a sensitivity of 84.4% and specificity of 71.8%. DCA showed greater net benefit than treat-all and treat-none strategies across clinically relevant threshold probabilities (20%\u201350%), with a net benefit of 0.319 at a 50% threshold probability. The CTSS may provide a pragmatic field-based triage tool to support early identification of athletes who may benefit from priority intervention, although external validation is needed before broader implementation in sports medicine settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0348820","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:34:21Z","timestamp":1788975261000},"page":"e0348820","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and internal validation of a field-based triage tool for lumbopelvic-hip dysfunction in collegiate athletes"],"prefix":"10.1371","volume":"21","author":[{"given":"Hung-Chun","family":"Huang","sequence":"first","affiliation":[{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Hsi","family":"Chou","sequence":"additional","affiliation":[{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]},{"name":"College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"],"department":["Department of Sports Medicine"]},{"name":"Kaohsiung Medical University Hospital","place":["Kaohsiung, Taiwan"],"department":["Division of Sports Medicine, Department of Orthopaedic Surgery"]},{"name":"School of Medicine, College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"],"department":["Department of Orthopaedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kung-Che","family":"Lee","sequence":"additional","affiliation":[{"name":"National University of Kaohsiung","place":["Kaohsiung, Taiwan"],"department":["Department of Athletic Performance"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Hua","family":"Chu","sequence":"additional","affiliation":[{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]},{"name":"College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"],"department":["Department of Sports Medicine"]},{"name":"Kaohsiung Medical University Hospital","place":["Kaohsiung, Taiwan"],"department":["Department of Medical Research"]},{"name":"Precision Sports Medicine and Health Promotion Center, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ing-Jer","family":"Huang","sequence":"additional","affiliation":[{"name":"National Sun Yat-sen University","place":["Kaohsiung, Taiwan"],"department":["Department of Computer Science and Engineering"]},{"name":"Digital Content and Multimedia Technology Research Center, National Sun Yat-sen University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Min","family":"Liang","sequence":"additional","affiliation":[{"name":"College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"],"department":["Department of Sports Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2199-4553","authenticated-orcid":true,"given":"Wen-Lan","family":"Wu","sequence":"additional","affiliation":[{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]},{"name":"College of Medicine, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"],"department":["Department of Sports Medicine"]},{"name":"Kaohsiung Medical University Hospital","place":["Kaohsiung, Taiwan"],"department":["Department of Medical Research"]},{"name":"Precision Sports Medicine and Health Promotion Center, Kaohsiung Medical University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"pone.0348820.ref001","article-title":"Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis","author":"F Wilson","year":"2020","journal-title":"Br J Sports Med"},{"key":"pone.0348820.ref002","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ptsp.2017.08.076","article-title":"Is core stability a risk factor for lower extremity injuries in an athletic population? 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