Systematic Review of Outcomes Reporting in Professional Baseball: A Call for Increased Validation and Consistency

• Published in: The American journal of sports medicine 2018-02, Vol.46 (2), p.487-496
• Main Authors: van der List, Jelle P., Camp, Christopher L., Sinatro, Alec L., Dines, Joshua S., Pearle, Andrew D.
• Format: Article
• Language: English
• Subjects: Athletes; Athletic Injuries - epidemiology; Athletic Injuries - therapy; Baseball - injuries; Humans; Medical treatment; Patient Reported Outcome Measures; Professional baseball; Research Design - standards; Return to Sport; Sports medicine; Studies; Systematic review; Treatment Outcome
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546517697690

Background: Historically, treatment efficacy of professional baseball injuries has been determined by assessing the return-to-play (RTP) rate or using patient-reported functional outcomes scores; however, these methods may not be sensitive and specific enough for elite athletes. As a consequence, performance-based statistics are increasingly being reported in the medical literature. Purpose: To (1) assess how treatment efficacy is currently reported in professional baseball players; (2) examine the variability in the reporting of these measures in terms of frequency, length of time followed, and units of measure; and (3) identify any attempts to validate these performance-based statistics. Study Design: Systematic review. Methods: All studies reporting treatment efficacy in professional baseball in PubMed, Embase, and Cochrane were identified. Data collected included frequency and method of reporting: RTP, functional outcomes, and performance-based statistics. Results: Fifty-four studies met all inclusion criteria. Of these, 51 (94%) reported RTP, 12 (22%) utilized functional outcomes, and 18 (33%) provided baseball-specific performance-based statistics to assess treatment efficacy. Great variability was seen in how follow-up was defined (games, seasons, months), duration of follow-up, and which performance-based statistics were utilized. None of the studies validated these performance-based statistics, determined minimal time of follow-up needed, or assessed the baseline variability in these statistics among noninjured players. Conclusion: Most studies reported RTP to determine treatment efficacy, but significant variability was seen in how players were followed. Similarly, great variability was noted in the type and number of performance-based statistics utilized. Additional studies are necessary to validate these measures and determine the appropriate length of time that they should be followed. Clinical Relevance: This study provides a clear overview of the current methods that are used to determine treatment efficacy in professional baseball players.