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

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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.

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