Page 52 - 《运动与健康科学》(英文)2024年第2期

174 S.A. Guevara et al.
response in the 2 weeks following this e-mail, a second corre- Each category was considered independently and not
spondence was sent to seek clarification, and if no response combined, as recommended by the PRISMA guidelines. Two
was received after a further 4 weeks, the articles were excluded authors (SAG and PC) independently completed risk-of-bias
due to an inability to confirm the triathlon distance or specific assessments for all included studies. For any discrepancies not
triathlon data. A third author (PC) was consulted in the event resolved through discussion, a third independent assessor
of a disagreement between authors for consensus. All studies (MD) was consulted to reach consensus. Case studies were not
were able to be classified using the track and field consensus assessed using a risk of bias tool, as these tools are designed to
statement, which defined a recordable health-related incident assess intervention-based studies, and in this review case
as “any physical or psychological complaint or manifestation studies only included reporting on the occurrence of specific
experienced by an athlete, irrespective of the need for medical health problems and not interventions.TaggedAPTARAEnd
18
attention or time loss from athletics activities”. TaggedAPTARAEnd
TaggedAPTARAH13. ResultsTaggedAPTARAEnd
TaggedAPTARAH22.4. Data extractionTaggedAPTARAEnd
TaggedAPTARAH23.1. Search resultsTaggedAPTARAEnd
TaggedAPTARAPData extraction was independently completed by 2 of the
TaggedAPTARAPThe electronic search of the relevant databases yielded 7998
authors (SAG and MLC) using a structured form that included
potentially relevant articles that were imported into the Covi-
extraction of the following: study design, surveillance period,
dence online platform (Veritas Health Innovation). After
participants characteristics (sex, age, race distances, experi-
removing 3840 duplicates and excluding another 4017 articles
ence level—mapped to The Foundations, Talent, Elite,
17 following the independent screening of titles and abstracts by 2
Mastery framework classification, which is a tool designed
reviewers (SAG and MLC), 143 articles remained to be
to assist sporting stakeholders in reviewing, planning and
assessed in full text. One article was identified through the
supporting athlete pathways). Injury and illness definitions
backward citation search after cross-referencing the reference
were mapped to the Injury Definitions Concept Framework
lists of the included articles and another through author corre-
classifications, which considers the clinical examination,
sports performance, and athlete self-perception. 19 Injury char- spondence. The most common reasons for exclusion were not
specifying the race distance (short-course or long-course) or
acteristics (number, type, location, nature, and mechanism),
including athletes competing in both short- and long-course
illness characteristics (number, illness symptoms, and affected
races, where the epidemiologic data could not be separated.
system), and summary measures of injury and illness (preva-
This resulted in 42 articles (26 cohort studies (Level 3), 1 case-
lence, incidence) were extracted if reported. A third author
control, and 15 case report studies (Level 4)) that were deemed
(PC) independently verified the extracted data. The authors of eligible and included in this review; a total of 9824 short-course
17 studies 9,10,2034 clarified questions regarding raw data.TaggedAPTARAEnd
triathletes were observed by the included studies (Fig. 1).TaggedAPTARAEnd
TaggedAPTARAFigure
TaggedAPTARAH22.5. Strength of evidenceTaggedAPTARAEnd
TaggedAPTARAPThe “Oxford Centre of Evidence-based Medicine—Levels
of Evidence” was used to determine the hierarchical level of
evidence of the articles according to the type of research ques-
tion and study design adopted by the full-text studies included
in this review. The highest level of evidence (Level 1) referred
to “systematic reviews”, and the lowest level of evidence
35
(Level 4) referred to “case-series and case reports”. TaggedAPTARAEnd
TaggedAPTARAH22.6. Risk of biasTaggedAPTARAEnd
TaggedAPTARAPRisk of bias was assessed using the NewcastleOttawa
Quality Assessment Scale created for assessment of non-
randomized studies, including case-controls and cohort
studies. 36 The NewcastleOttawa Quality Assessment Scale
allows question customization to reflect the review questions
of interest. 37 A tailored version of the NewcastleOttawa
Quality Assessment Scale, based on Toohey et al., 38 was
created in a checklist format for specific injury and illness
research (Appendix 2 of online Supplementary materials).
Cohort and case-control studies were assessed in accordance
with their study design in 3 categories: selection of participant
groups, comparability of different participant groups, and
outcome/exposure result. Assessed studies could score a Fig. 1. Preferred Reporting Items for Systematic Review and Meta-Analyses
maximum score of 4, 2, and 3 for these respective categories. flow chart.TaggedAPTARAEnd