Protocol: Expert consensus on a standardised definition and severity classification for adverse events associated with spinal and peripheral joint manipulation and mobilisation: protocol for an international e-Delphi study

doi:10.1136/bmjopen-2021-050219

Table 1

Eligibility criteria for expert consensus panel

Expert group Inclusion criteria
Researchers
≥2 peer reviewed publications (scoping or systematic review, randomised controlled trials, prospective cohort, retrospective case-control or case series, qualitative studies, basic science mechanistic) relating to patient safety or adverse events and SMT or MOB in the previous 10 years

Manual therapy clinicians
A clinical professional with ≥7 years of clinical practice experience using SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Patients
An adult (≥18 years old) who has not received any training in SMT or MOB and has received SMT or MOB from a healthcare professional (eg, chiropractors, naprapaths, osteopaths and physiotherapists) to manage a musculoskeletal condition in the last 12 months

Medical doctors
A medical doctor who has a professional interest in SMT or MOB (eg, refers patients to manual therapy providers, has treated patients who presented with an adverse event potentially related to SMT or MOB) and/or adverse events following conservative treatments

Manual therapy students
A student (≥18 years old) actively enrolled in a professional programme that includes SMT or MOB to manage musculoskeletal conditions in adults in their curriculum (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Professional regulatory body representatives
An adult (≥18 years old) who is involved with local or federal policy and regulations for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Malpractice insurance representatives
A professional malpractice insurance employee (≥18 years old) who is involved with malpractice claims for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Lawyers or judges
A licensed legal professional who has an interest in medicolegal actions involving adverse events following conservative treatment and/or professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Data analysts or informatics/electronic health record representatives
An adult (≥18 years old) with expertise in collecting standardised health data including, but not limited to adverse events, for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists).

MOB, mobilisation; SMT, spinal and peripheral joint manipulation.

Expert group	Inclusion criteria
Researchers	≥2 peer reviewed publications (scoping or systematic review, randomised controlled trials, prospective cohort, retrospective case-control or case series, qualitative studies, basic science mechanistic) relating to patient safety or adverse events and SMT or MOB in the previous 10 years

Manual therapy clinicians	A clinical professional with ≥7 years of clinical practice experience using SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Patients	An adult (≥18 years old) who has not received any training in SMT or MOB and has received SMT or MOB from a healthcare professional (eg, chiropractors, naprapaths, osteopaths and physiotherapists) to manage a musculoskeletal condition in the last 12 months

Medical doctors	A medical doctor who has a professional interest in SMT or MOB (eg, refers patients to manual therapy providers, has treated patients who presented with an adverse event potentially related to SMT or MOB) and/or adverse events following conservative treatments

Manual therapy students	A student (≥18 years old) actively enrolled in a professional programme that includes SMT or MOB to manage musculoskeletal conditions in adults in their curriculum (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Professional regulatory body representatives	An adult (≥18 years old) who is involved with local or federal policy and regulations for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Malpractice insurance representatives	A professional malpractice insurance employee (≥18 years old) who is involved with malpractice claims for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Lawyers or judges	A licensed legal professional who has an interest in medicolegal actions involving adverse events following conservative treatment and/or professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists)

Data analysts or informatics/electronic health record representatives	An adult (≥18 years old) with expertise in collecting standardised health data including, but not limited to adverse events, for professions that use SMT or MOB to manage musculoskeletal conditions in adults (eg, chiropractors, naprapaths, osteopaths and physiotherapists).