NATA Pronouncements Committee Meeting

6/17/2009

Present:

  • Eric Sauers - Chair
  • Linda Meyer
  • Nikki McBrier – Penn State conference call
  • Ty Hopkins
  • Susan Rozzi
  • Cindy Trowbridge
  • Jimmy Onate – minutes
  • Doug Casa
  • Carrie Docherty

Welcome – done

2008 Minutes approval

  • Motion to approve – Ty Hopkins
  • Second – Linda Meyer
  • Approved by all

Council chair report - Doug Casa

  • Transition – finish term June 2010 – Ty Hopkins incoming Council chair - will lead next meeting June 2010
  • Any PS not published in the next year Ty will take over
  • Doug – chaired for 8 yrs and committee for 11 – wanted to say “Thank you” for all who have served
  • One cool thing – London 6 weeks ago – University of “Hull?” – NATA position statements on powerpoint in room – emergency policies
  • PS make a huge contribution to promoting the AT profession
  • Need to find replacement for Doug to keep council at 8

Review the development of position statement process

  • Idea at pronouncements committee mtg or ideas from membership
  • Key is lead author – always ATC with expertise in area and writing ability, but motivation is key!
  • Distribution of committee
  • 2 clinical ATCS
  • Research in area
  • MD’s in area
  • Board of Directors approve idea
  • Subcommittee 3 people from PC
  • Liaison is key communicator with lead author
  • Ty Hopkins being transitioned into Doug’s role of supervising all subcommittees
  • Susan Rozzi may be rotating off – tabled for later discussion
  • Lead author gets voted for approval – 1 yr timeline started
  • Liaison sends packet to author
  • Ty asked to get a website for lead author access – needs to happen at NATA for streamline process
  • Can/Is NATA making a PC website?
  • PC position statement packet – April 2008 is most updated version – needs to be updated
  • Make folder for each statement
  • Conflict of interest forms returned to Ellen Satlof immediately
  • Per position statement liaison needs to follow-up
  • Develop a method for Ellen to provide update to liaison
  • Lead author needs to know any conflict of interests early in the process
  • Ellen – email conflict of interest update to lead author and liaison
  • Leslie at JAT encouraged to be contacted immediately

Lead Author instruction

  • Define committee member roles
  • Underestimated how complicated the process
  • An instructional technique document from previous lead authors of PS
  • Someone has to be responsible to merge the document into a singular manuscript
  • Written document to aid lead authors would be excellent
  • PC create examples of how lead author can organize a PS
  • Define roles upfront – but sometimes difficult to define upfront due to evolving process
  • At 3months author contributions are returned to Ellen
  • Length of document – make sure to be concise
  • Authors pay attention to manuscript guidelines (pages, references, etc…)
  • Liaison encourage to keep lead authors under guidelines
  • Key is getting packet out to authors
  • Last meeting encouraged lead authors to use Google docs – is this still a useful idea?
  • First drafts are being completed with more content as compared to years past – try to avoid entire sections of “to be completed at later date-waiting etc…” – but a few areas are okay within a typical timeframe – encourage 1st draft to be
  • Previous position statements should be encouraged to be used as guidelines
  • Recommendations should be free-standing bulleted items
  • Levels of evidence = SORT for this committee
  • Send back to authors as blinded review – committee A, B, C
  • Caution on track changes – not blinded review
  • If used track changes – let reviewers know that this is the case upfront and that blinded review may not actually be occurring.

*** Should external reviewers be blinded to authors?

*** Should lead authors and external reviewers be connected if needed?

Possibly Re-define the process of each position statement draft development?

  • First review of initial draft template needed?
  • Input – Output concept
  • General recommendations for each sub-committee member to evaluate
  • General overview – not a 100 bullet item
  • Doug’s feedback was good idea – no further discussion of who or how this would be completed
  • Supplements PS discussion – how to handle problems with external reviewers etc… - tabled for later discussion
  • Development of external reviewers
  • Clinicians (ATC, MD), researcher experts
  • Susan Rozzi will be sending out format and letter that she uses
  • Can JAT manage the external review – Eric Sauers parting thoughts?
  • Doug – likes idea – would be much easier
  • Associate editor is the liaison – reviews come back to liaison
  • Need blessing from JAT
  • Make sure to try to keep external reviewer contact personal
  • Re-organize position statement process? Not needed at this point in time – may revisit next year
  • Purpose of each level of review?
  • Redundancy built in
  • Sub-committee – technique, format, process – not expertise
  • When should committee look at document?
  • Used to be earlier in the process – but overload due to volume has become an issue
  • Bumped to after external reviewers due to volume
  • Carrie Docherty: Full committee – is that basically a rubber stamp? Yes – most likely and that is a good thing
  • Don’t rush to external review until sub-committee has thoroughly agreed to process

***Lay-out the exact process for PS

  • Do NOT RUSH process!
  • Sub-committee should make sure that PS has a clinical AT viewpoint and also make sure that prior to external review that manuscript is polished as best as possible prior to their expert review.
  • Expert external reviewers with opposing viewpoints should be recruited
  • At least 5 external expert reviewers
  • With at least 2 everyday clinicians
  • Preferably 1 MD and a few PhD’s
  • Authors packet sent out by sub-committee liaison when author group has been approved
  • NATA liaison should manage this entire process? Administrative process needs more support!
  • Future PC WEBSITE
  • projected date of completion
  • author group
  • updates
  • author guidelines
  • individual sites per PS
  • previously published documents (pdf, powerpoints)
  • new ideas/topics
  • involve – writing group member, external reviewer
  • clinical implementation? Might not be ready yet
  • SORT guidelines to be used on all position statements – maintain uniformity
  • Thank you notes to authors – copied 1st page framed of article to each author with hand-written note
  • Spine thank you due next
  • “Committee” changes to “Council” officially at end of this meeting – terms for members are n/a
  • NATA Board Report must be submitted 2x per year
  • Reviewed current NATA report process
  • JAT highly concerned about “dates” for completion and publication
  • Most take up 2-3 articles of space
  • PS current status update
  1. Cold – completed – yeah! Pertinacity pays off
  2. Pre-hospital care of the spine – excellent job by Carrie Docherty and Eric Swartz

i)Great - high impact

ii)See galley proofs as long as possible

  1. Weight control issues in weight class sports

i)No levels of evidence imbedded due to start date - this summer re-draft with SORT

ii)External reviewers – Margot Putikian, Leslie Bonci

iii)Formatting major problem – content seems fine

iv)Sub-committee expecting draft at end of summer

v)Estimated time for release – summer 2010

vi)Doug staying on to oversee

  1. Skin

i)Potentially march or may 2010

  1. Sudden Cardiac Death

i)Tabled due to Inter-association task force released March 2007

  1. Dislocations

i)Susan – June 2010

ii)At 2nd review sub-committee

iii)Jimmy & Nikki to be added to sub-committee

iv)Doug – liaison

  1. Skin Disorders

i)Nikki replaced Darin

ii)Ty on

iii)Liaison is Susan

iv)External Review still waiting for all reviews

v)MRSA occurrence shows the importance of waiting

vi)Press conference next summer

vii)Color pictures which will cost money – JAT

viii)May have to link from position statement to website for all pictures

ix)Aim ready for Spring 2010

x)JAT release in July for Marketing Press Conference

  1. Nutritional Supplements

i)Trouble with format/conceptual design – lead author very amenable to changes/suggestions

ii)8 external reviewers

(a)2 ATC

(b)2 MD

(c)4 non-ATC PhD’s

iii)Doug and Jimmy reviewed

iv)Recommend eliminating

(a)Hydration/Fluids – not to be included

(b)Macronutrients needed?Daily requirements not needed?

v)2 main external reviewer comments

(a)Needs major revisions of aims/goals

(b)Very important topic – but not treated seriously

vi)We don’t enough pure scientists on the writing group – need more scientists on writing group

vii)Jackie Buell – lead author – is very receptive to ideas

viii)How do we ensure a better writing group!

(a)Go back to sub-committee member prior to back out to external reviewers

(b)Need a MD on writing group

ix)Add Bob Murray? Doug or Linda will discuss with lead author

1)Grouping in topics?

2)Formal process of when supplements should be received?

i)Ty on – Doug off – will not be done in 12 months

  1. Illegal Performance Enhancing Supplements

i)Commitment for 1st draft August 2009

ii)4 years with little progress

iii)We may need to move on?

iv)May need to replace lead author - Robert Kersey

(1)Writing group developed December 2007

(2)Plan A – provide August 2009 update

(3)Plan B – propose new lead author possibility and reduce role to team member

(4)Nikki – contact Dr. Buckley at PSU for update and potentially take on lead authorship

  1. Overuse injuries in pediatric athletes

(1)1st draft in – good response and well written

(2)Plan is July to address comments

(3)End of July/August 2009 with revisions to sub-committee

(4)Spring 2010 target goals

(5)Age range problem: 2-21 is medical term for pediatric

(6)Children vs. Adolescents break-out? Discuss with lead author

  1. Pre-participation exam and disqualifying conditions

(1)Removed Clifton as team member; Texas ATC to be added –with experience with echo

(2)Recommendations – Cardiovascular - Lab Screenings in

(3)Fall 2009 1st draft

  1. Dental injuries - Mouthguards

(1)Good communication

(2)Each author role outlined well

(3)Good 1st draft to sub-committee in Fall 2009

  1. Fluid Position Statement Re-write

(1)Co-authors of initial fluid position statement provided updated feedback 2 rounds

(2)May – June release in 2011

  1. Ankle Position Statement

(1)Jimmy take over liaison role

(2)Committee consists of Jimmy/Susan/Linda – Ty and Carrie defer due to being writing members

???Eric – if ATC’s not experts on topic – should NATA be writing position statement

Doug – counterpoint that ATC’s act as conduit of knowledge and utilize the information as needed

***Doug’s suggestion as Liaison = Gently, Positively Nudge Lead Authors

Current Update of Sub-Committees: (Liaison / Sub-committee)

Cindy: 2 / 2

Linda: 2 / 2

Carrie: 0 / 2

Lightning – Carrie/Susan/Cindy

  • Katie Walsh – lead author in 2001 – but did not do lead author role
  • Very excited about manuscript

Ty: 1 / 3

Susan: 1 / 5

Nikki: 0 / 3

ACL – Nikki/Ty/Carrie/Cindy

  • 2 documents:
  • 1 applied - Sandy Schultz
  • 1 research – DarinPadua – writing group approved

Jimmy: 0 / 2

Ankle – Jimmy/susan/linda

  • Writing Group approved

Two are ready for 10-year Renewal Plan

(1)Emergency Procedures Action Plan – needs to be updated

  • Lead Author proposed – Ron Courson

(2)Heat Illness – definitely needs to be updated

  • Lead Author – Doug Casa

Doug’s Coup de Grace

  • 8 leading causes of death in sports
  • Develop Position Statement on “Prevention of Sudden Death in Sport”

On-field emergency acute actions

INVITE LEAD AUTHORS FROM PREVIOUS POSITION STATEMENTS

  • Eric Sauers recommends title change to include concepts of Prevention, Recognition, Treatment
  • Doug Casa to discuss with Kevin Guskiewicz co-chair lead authorship

Writing group from lead authors of previous position statements pertinent to sudden death in sport

  • EMT organization involvement?
  • NATA specific contribution from ATC lead authors
  • Future potential endorsements from medical groups/EMT etc… - to be discussed at later date

The 3 New PS: liaison would be Ty Hopkins

  • Heat Illness 10yr update
  • Emergency Action Plans 10yr update
  • Prevention of Sudden Death in Sport

Future Possible Topics:

  • Sickling
  • Cardiac

Item #9 new members and potential future members

Need to replace Doug Casa

  • Kelly Huxall
  • Allison Snyder
  • Steve Zinder
  • Troy Blackburn
  • Joe Myers

???Linda Meyer– what is the length of term of appointment?

  • Can add number of individuals as desired – due to council status
  • Adding members proposal to NATA
  • Future meetings NATA may not pay for hotel – thus meeting may need to be 1st afternoon of meeting – may be difficult with travel plans and other meetings

Item #10 Working with JAT

  • Leslie work from start – get reference list early on
  • Always provide continual update on time frame to reduce surprises

Item #11Other organizations involvement

  • is an arduous task – but may be beneficial?

#12 – NATAREF stuff/solutions – how to move ahead with NATAREF

  • Linda Meyer? – how much marketing is being done with MD’s? disseminate information to state board group of MD’s – need to do more external marketing to physician group
  • Coordinate a meeting with NATAREF for future
  • Move PC under NATAREF umbrella move re-visited and tabled currently
  • Teresa Foster-Welch is taking over executive directorship of NATAREF 2009
  • Marketing/Education from NATAREF with PS documents
  • CONDUIT – DOUG – PC and ATC act as conduits of information
  • Be cautious of replacing position statement with simple statements to “water down” information too much
  • District meeting implementation of Position Statements
  • NATAREF help promote “experts” by establishing “endowment” fund to speak on special topics concept has been proposed “Position Statement Endowment Funds”
  • Coordinate a PC and NATAREF conference call

#13 Change NATA from Baltimore to Philadelphia

  • Potential schedule for meeting
  • Morning of 1st Day of Annual meeting or Meet in March (much more costly – hotels, airfare)
  • Discuss with NATA concerning funding/support needs

#14 – already completed

#15 NATA 2010 Symposium – Cyndi in charge

  • Mouthguard
  • Pre-participation Exam
  • Eric suggests - contact Ellen Satloff to complete program committee plan

NATA 2011 Symposium

  • Prevention of Sudden Death in Sport

#16 NATA Position Statement book and questions

  • Thank you Susan for educational questions
  • $20
  • 4 items need to be added
  • Cold
  • Spine
  • Cardiac
  • Pre-season Heat Acclimatization
  • Could NATAREF fund?
  • Could membership get free following $25 NATAREF donation?

Wrap-up

Thank you gift to Eric Sauers – leaving PC!