Defining and classifying adverse events following joint manipulation and mobilization: An international e-Delphi...

Area of Science:

• Musculoskeletal health
• Patient safety
• Clinical interventions

Background:

• Spinal and peripheral joint manipulation (MAN) and mobilization (MOB) are common treatments for musculoskeletal issues.
• Adverse events (AE) following MAN and MOB lack standardized definitions and classification systems.
• Existing AE reporting lacks consistency, hindering safety research and practice.

Purpose of the Study:

• To establish an inter-professional and international standardized definition and severity classification for AE following MAN and MOB.
• To improve consistency in reporting and understanding of AE in manual therapy.
• To enhance patient safety in the management of musculoskeletal conditions.

Main Methods:

• Sequential mixed-methods study combining an electronic Delphi process (e-Delphi) with focus groups.
• Involved inter-professional and international expert stakeholders over three e-Delphi rounds.
• Focus groups explored e-Delphi findings to deepen understanding of consensus and disagreements.

Main Results:

• Consensus was achieved on standardized severity categories for AE: mild, moderate, severe, and catastrophic.
• Two key domains were identified to differentiate severity: symptom intensity and patient impact.
• Consensus was not reached on a universally standardized definition for AE following MAN and MOB.

Conclusions:

• Standardized AE severity classification for MAN and MOB is a significant step towards improved patient safety.
• Further research and discussion are needed to establish a unified AE definition.
• Findings will inform future safety research, clinical practice, and inter-professional communication regarding manual therapy AE.