Healthcare Professional Identified Priorities for a New Musculoskeletal Examination Scoring System for People With Hemophilia-an International Consensus.

INTRODUCTION: The accurate physical examination of musculoskeletal (MSK) health is an essential part of proactive best practice care of people with hemophilia and must be consistently monitored in clinic. In response to current MSK tool limitations, the Musculoskeletal Health Expert Working Group (MSKH EWG) of the International Prophylaxis Study Group (IPSG) has identified developing an improved MSK scoring system a priority. AIM: To identify the priority needs for healthcare professionals examining the MSK health of people with hemophilia in clinic. METHODS: Priorities were identified through a modified Delphi consensus process and an expert meeting with the members of the MSKH EWG. Three iterative surveys were distributed worldwide to healthcare professionals who were participants of the World Federation of Haemophilia (WFH) MSK Committee meetings. RESULTS: The modified Delphi process identified priorities of these healthcare professionals (n = 78) through surveys and an expert meeting (n = 13). The three surveys achieved response rates of 58%, 54% and 55%. The top two priorities, as to why a new MSK scoring system should be developed, were 1) current tools cannot detect the earliest and subtle changes of hemophilia, and 2) current tools are too time consuming. The top two attributes and purposes of a new MSK scoring system were to 1) measure the earliest changes of hemophilia, and 2) measure joint health changes over the course of time. CONCLUSION: The Delphi process successfully identified which future MSK examination priorities should be considered in the development of an improved MSK scoring system for clinical use.