Canadian Sport Institute Pacific, Victoria, British Columbia, Canada
Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada.
Br J Sports Med. 2023 Sep;57(17):1109-1118. doi: 10.1136/bjsports-2023-106914.
Relative Energy Deficiency in Sport (REDs) has various different risk factors, numerous signs and symptoms and is heavily influenced by one's environment. Accordingly, there is no singular validated diagnostic test. This 2023 International Olympic Committee's REDs Clinical Assessment Tool-V.2 (IOC REDs CAT2) implements a three-step process of: (1) initial screening; (2) severity/risk stratification based on any identified REDs signs/symptoms (primary and secondary indicators) and (3) a physician-led final diagnosis and treatment plan developed with the athlete, coach and their entire health and performance team. The CAT2 also introduces a more clinically nuanced four-level traffic-light (green, yellow, orange and red) severity/risk stratification with associated sport participation guidelines. Various REDs primary and secondary indicators have been identified and 'weighted' in terms of scientific support, clinical severity/risk and methodological validity and usability, allowing for objective scoring of athletes based on the presence or absence of each indicator. Early draft versions of the CAT2 were developed with associated athlete-testing, feedback and refinement, followed by REDs expert validation via voting statements (ie, online questionnaire to assess agreement on each indicator). Physician and practitioner validity and usability assessments were also implemented. The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.
运动性相关能量消耗(REDs)有多种不同的风险因素、多种体征和症状,且受环境影响较大。因此,不存在单一的经过验证的诊断测试。2023 年国际奥委会 REDs 临床评估工具-V.2(IOC REDs CAT2)采用三步法:(1)初步筛查;(2)根据任何确定的 REDs 体征/症状(主要和次要指标)进行严重程度/风险分层;(3)医生主导的最终诊断和治疗计划,与运动员、教练及其整个健康和表现团队共同制定。CAT2 还引入了一个更具临床细微差别的四级信号灯(绿色、黄色、橙色和红色)严重程度/风险分层,并附有相应的运动参与指南。已经确定了各种 REDs 主要和次要指标,并根据科学支持、临床严重程度/风险和方法学有效性和可用性进行了“加权”,允许根据每个指标的存在或缺失对运动员进行客观评分。CAT2 的早期草案版本是在运动员测试、反馈和改进的基础上开发的,然后通过投票声明对 REDs 专家进行验证(即,在线问卷以评估对每个指标的一致性)。还实施了医生和从业者的有效性和可用性评估。IOC REDs CAT2 的目的是协助合格的临床专业人员对 REDs 进行早期、准确的诊断,并进行适当的临床严重程度和风险评估,以保护运动员的健康,防止 REDs 的长期和不可逆转的后果。