Development of an Online Dance Injury Surveillance System (ODISS): A Delphi Consensus, Usability, and Feasibility Study.

Objectives: To develop an optimal outline for an online dance injury surveillance system (ODISS) based on expert consensus from a Delphi survey and evaluate the system's usability and feasibility within a fictional folk-dance academy setting.

Background: Dance is characterized by intensive training and performance, which can elevate susceptibility to injuries. Robust surveillance systems are required to understand and mitigate this injury risk. Current systems exhibit limitations and lack uniformity.

Methods: A Delphi panel of 35 stage 1 experts were recruited through snowball sampling from online professional networks, professional dance associations, organizations, and academies. Inclusion criteria were ≥18 years of age, fluent in English, and worked as dance academics or researchers, clinicians, instructors, managers, or competitive or professional dancers. These stage 1 experts were provided with a preliminary outline of a dance injury surveillance system that covered 6 domains: dancer demographics and screening, exposure monitoring, injury identification and classification, injury management, dancer recovery and system access. Stage 1 experts then voted on the importance of and provided feedback on different design elements within each domain across 2 Delphi survey rounds to determine a consensus system design outline. A pilot system was then developed and evaluated by stage 2 experts, who were end-users and included dance instructors and administrators from various dance academies/institutions recruited through direct invitations. These stage 2 experts utilized the System Usability Scale (SUS) and System Feasibility Measure (SFM) based on application to a fictional folk-dance injury scenario.

Results: In survey round 1, the stage 1 experts reached consensus to include 30 elements and exclude 3 elements and demonstrated mixed opinion on 30 elements that were revised into 14 elements for further consideration in round 2. All but 1 element reached consensus to include after round 2. System testing demonstrated low marginal usability (SUS score: 58.2% ± 11.6%). Stage 2 experts agreed or strongly agreed the system was feasible for 86.7% ± 10.3% of SFM statement ratings. Key areas for improvement identified from stage 2 expert feedback were a need for an improved user interface and strategies to reduce data entry time burdens. A common suggestion was to integrate more dropdown and checkbox response options within the interface to increase efficiency of data entry.

Conclusion: This study established a Delphi-consensus on the essential design elements for an ODISS. Expert evaluation resulted in a usable and feasible online system that can be used to improve future dance injury surveillance research across dance populations.Level of EvidenceThe usability and feasibility portion of the study falls under Level 3 evidence according to the Centre for Evidence-Based Medicine (CEBM) hierarchy. Whereas the Delphi portion of the study is at Level 5 Evidence on the CEBM hierarchy.