Methodological Framework for Global Expert Consensus on Musculoskeletal Infection: Establishing the ICM 2025...

Study DesignMultiphase methodological framework for international consensus development.ObjectiveThis study describes the structured methodology adopted by the International Consensus Meeting on Infection - ICM 2025 (Spine Section) to formulate globally endorsed recommendations in musculoskeletal infection. The initiative aimed to standardise best practices in prevention, diagnosis, and management through a collaborative, evidence-driven process.MethodsThe consensus was developed through an 11-phase process spanning over 2 years, involving more than 100 global experts in orthopaedic infection. Phases included expert selection, question generation and ranking, systematic evaluation, literature synthesis, inter-delegate discussions, and a final face-to-face meeting. Recommendation statements were refined via iterative feedback and consensus-building techniques, including asynchronous dialogue and voting thresholds. Delegates were selected based on academic merit and regional representation, ensuring a diverse and multidisciplinary panel. Structured timelines ensured transparency and accountability across all phases.ResultsThe outcome was a series of actionable, context-sensitive recommendations, reflecting high-level agreement across diverse healthcare settings. The methodology facilitated consensus on complex infection scenarios where definitive evidence was lacking, incorporating expert judgment and current literature.ConclusionThe ICM 2025 (Spine Section) framework demonstrates a robust model for consensus development in orthopaedic surgery. Its transparent and scalable design ensures reproducibility for future topics requiring global guidance. This methodology sets a precedent for collaborative guideline generation in musculoskeletal care.