Yung Kate K, Ardern Clare L, Serpiello Fabio R, Robertson Sam
Institute for Health and Sport, Victoria University, Melbourne, Australia.
Musculoskeletal and Sports Injury Epidemiology Centre, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.
Sports Med Open. 2022 Apr 13;8(1):52. doi: 10.1186/s40798-022-00440-z.
Return-to-sport (RTS) decisions are critical to clinical sports medicine and are often characterised by uncertainties, such as re-injury risk, time pressure induced by competition schedule and social stress from coaches, families and supporters. RTS decisions have implications not only for the health and performance of an athlete, but also the sports organisation. RTS decision-making is a complex process, which relies on evaluating multiple biopsychosocial factors, and is influenced by contextual factors. In this narrative review, we outline how RTS decision-making of clinicians could be evaluated from a decision analysis perspective. To begin with, the RTS decision could be explained as a sequence of steps, with a decision basis as the core component. We first elucidate the methodological considerations in gathering information from RTS tests. Second, we identify how decision-making frameworks have evolved and adapt decision-making theories to the RTS context. Third, we discuss the preferences and perspectives of the athlete, performance coach and manager. We conclude by proposing a framework for clinicians to improve the quality of RTS decisions and make recommendations for daily practice and research.
重返运动（RTS）决策对临床运动医学至关重要，其特点往往是存在不确定性，如再次受伤风险、比赛日程带来的时间压力以及来自教练、家人和支持者的社会压力。RTS决策不仅对运动员的健康和表现有影响，对体育组织也有影响。RTS决策是一个复杂的过程，它依赖于对多种生物心理社会因素的评估，并受到情境因素的影响。在这篇叙述性综述中，我们概述了如何从决策分析的角度评估临床医生的RTS决策。首先，RTS决策可以解释为一系列步骤，其中决策依据是核心组成部分。我们首先阐明从RTS测试中收集信息时的方法学考量。其次，我们确定决策框架是如何演变的，并使决策理论适用于RTS情境。第三，我们讨论运动员、表现教练和经理的偏好与观点。我们通过为临床医生提出一个提高RTS决策质量的框架并为日常实践和研究提出建议来得出结论。
