What impact have the IOC medical consensus statements made on athlete health? A survey of medical commissions from National Olympic/Paralympic Committees and International Sports Federations.

Background: The International Olympic Committee (IOC) Medical and Scientific Commission has supported collating and sharing evidence globally by developing sports medicine consensus statements ('Statements''). Publishing the Statements requires substantial resources that must be balanced by use and impact on policy and practice. This study aimed to gain a better understanding of awareness and uptake of the Statements globally through a survey of the National Olympic Committees (NOC), National Paralympic Committees (NPC) and International Federations (IF). Method: A cross-sectional survey of medical commission representatives from NOCs/NPCs/IFs. A structured questionnaire was distributed through the IOC head office, informed by prior research. Questions comprised a mix of closed and open-text responses with results presented descriptively by organisation type and total. Results: 55 responses were included: 29 (52%) from NOC/NPC representatives (response rate 14%) and 26 (47%) from IF representatives (response rate 63%). All Statements had been used by at least one respondent, with the Statement addressing concussion ranked highest (used by 33/55). The main barriers to use were financial limitations (n=21), club/sport culture and behaviours (n=19) and lack of understanding from coaches/team sport personnel (n=19). Participants believed the Statements were a successful strategy for improving athlete health (n=39/51 agree or strongly agree). Conclusion: There was clear support for the continued development of sports medicine guidance, including in the format of these Statements. To ensure Statements lead to demonstrable health benefits for athletes, input from athletes, coaches and supporting staff is needed, as well as clearer identification of the purpose and audience of each topic developed.