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Appendix F : Comments from Peer review/ pilot
Comments from Peer review/ pilot
“Few comments. It reads well, is very comprehensive and does the job. The summary tables of guidelines are an excellent idea. My only comment would be to define more clearly the purpose of the document and who it is for, and to comment on what happens in the future - what do you feel needs to be done”.
This has been addressed in the introductory statement and in the conclusions
“Thank you for seeking my impressions of the “guidelines”. Please extend my congratulations to the panel for a tremendous effort in putting the developments of recent years into a more sensible reasoning behind the time-honoured acronym. I am not without experience of a similar venture and I fully appreciate the demands inflicted on time and effort. Apart from nit-picking comments in the margins, my only real concern is of a more general nature, concerning”protection”.
The term “first aid” is never used and “early management” is the statement of choice. I can’t decide whether the panel had in mind the chap/ chapess who is running onto the pitch (ie the sharp end of sports medicine) or the one in a clinic at HQ or the physio in A & E ; on Monday morning”.
This has been addressed by adding “immediate” to qualify the phrase “early management”
“GREAT! WONDERFUL! BRILLIANT! Hows that then? I actually enjoyed it so much I’ve finished it already. Well presented and easy to read. I like the way you say what you’re going to say, say it again, summarise and then tabulate it. Couldn’t be clearer - my congratulations to you all. There are a few minor type errors, and I’ll point them out if you want when I see you next.
No comment! (The manuscript was sent for professional editing)
(verbal comments) “…add “haematuria” to abdomino-thoracic injury; redefine head injury/ unconsciousness to include “altered cerebral function, leading to disturbed consciousness, vomiting, drowsiness or amnesia”. Change the order to alphabetical, to avoid any sense of hierarchy (p2). Give examples of superficial nerves (p22). Change “grating” to “crepitus” in flow-chart. Otherwise, a comprehensive and well-written document”.
Changes made as suggested
“Many thanks for asking me to review your guidelines. I thought they were extremely useful and provided a clear outline of the premises or evidence underlying PRICE. I only have a few suggestions.
- I would place objectives and the need for guidelines at the very beginning
We felt that the definition of terms and a clear statement on the parameters of the guidelines should come first
- The epidemiology is good and drawing attention to the Sheffield survey is excellent as are the other references
No comment
- The process of the development of the guidelines is interesting, but might be better served in the appendix
We have summarised this in the text, and put the detailed comments / responses in Appendix A
- The appendices are not labelled yet
This has since been done
- Although the phrase biological bases is used in the opening statement 5.1, it is referred to thereafter as biological evidence. This is somewhat misleading, as empirical proof should itself be referred to as evidence-based, in line with current vogue. In turn, biological bases should be rephrased, something like scientific foundation or premis or even physiological foundation
We have based this on the terminology proposed by Bogduk and Mercer (1995), but have added some explanatory statements relating to the nature of biological and empirical evidence
- · Section 6, each subheading should be numbered or started on separate pages for clarity
Subheadings have been numbered and underlined. Layout will be further considered before publication
- I found the totals and % of total responses confusing. It might be simpler to have one initial % and let people extrapolate back
The detailed information on the results of the questionnaire have been removed, and a summary included instead.
- The summary of the guidelines is excellent, and I would round them off by saying that many can be considered as a continuum and can overlap. “As both our understanding of soft tissue inflammation and the modalities available for its modifcation continues to develop, these guidelines will obviously need revising with a view to the duration and timing of interventions…”