We Choose to Call it ‘Degenerative Cervical Myelopathy’: Findings of AO Spine RECODE-DCM, an International and Multi-Stakeholder Partnership to Agree a Standard Unifying Term and Deﬁnition for a Disease

Global Spine Journal, 2024 · DOI: 10.1177/21925682221111780 · Published: February 1, 2024

Neurology Spinal Disorders Research Methodology & Design

Simple Explanation

Degenerative cervical myelopathy (DCM) lacks a universally accepted name, creating obstacles in diagnosis, treatment, and research. This study aimed to establish a standard term and definition for DCM through a consensus process involving various stakeholders. The process involved a literature review, interviews, and surveys to identify candidate terms and definitions. Stakeholders, including surgeons, healthcare professionals, and patients, participated in selecting their preferred term and contributing to the definition. Degenerative Cervical Myelopathy was chosen as the unifying term, and a definition was created based on the input of stakeholders and analysis of existing disease definitions. This consistent term and definition are expected to improve education and research efforts related to DCM.

Study Duration

Not specified

Participants

248 members for term selection, 317 members for definition. Surgeons, healthcare professionals, and people with DCM or their supporters.

Evidence Level

Not specified

Key Findings

1
The study selected 'Degenerative Cervical Myelopathy' (DCM) as the unifying term for the condition.
2
A consensus definition of DCM was developed, describing it as a progressive spinal cord injury caused by narrowing of the cervical spinal canal.
3
The process used to reach consensus on the term and definition can be used as a model for other conditions.

Research Summary

The study aimed to address the inconsistency in the naming and definition of cervical myelopathy caused by degenerative changes to the spine. Through a structured, iterative consensus process involving multiple stakeholders, 'Degenerative Cervical Myelopathy' (DCM) was selected as the unifying term. The study developed a consensus definition for DCM as a progressive spinal cord injury resulting from the narrowing of the cervical spinal canal, which can support future education and research initiatives.

Practical Implications

Improved Communication

Adopting a unified term facilitates clearer communication among healthcare professionals, patients, and researchers.

Enhanced Research

A standard definition enables more consistent and comparable research studies on DCM.

Increased Awareness

Using a common term can improve public awareness and understanding of DCM.

Study Limitations

1
The term 'DCM' was used throughout the project, which may have introduced unconscious bias.
2
The study acknowledges that the definition of DCM remains uncertain, requiring a balance between essentialist and nominalist approaches.
3
The need for widespread adoption of the selected term and definition is crucial for the initiative's success.

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