BESS patient care pathway: Tennis elbow

Harvinder Pal Singh*, Adam C. Watts, Marcus Bateman, Timothy Batten, Somashree Chatterji, Kuen Chin, Han Hong Chong, Cameron Dott, Ahmed Elgebaly, Atilla Emin, Jonathan Evans, David Field, Rachael Fisher, Zaid Hamoodi, Ben Hughes, Mo Imam, Val Jones, Ameen Jubber, Ralph Mitchell, Veena PatelJoideep Phadnis, Lisa Pitt, Kannan Rajesparan, Abbas Rashid, Paul Robinson, Simon Robinson, David Shields, Alastair Stephens, Jojo Steveney, Andrew Stone, Habib Syed, Shannon Tse, Andrew Wright

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

2 Citations (Scopus)


This article provides a guidance summary for the management of lateral elbow tendinopathy (LET) using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of the rating quality of the literature and grading the strength of available evidence. The process began by assembling a guideline development group of volunteers including orthopaedic surgeons, trainees, physiotherapists, rheumatologists, radiologists and patients. Virtual meetings were organised to set out explicit PICO questions, including specification of all important outcomes (including patient reported tennis elbow evaluation (PRTEE) as an important primary outcome) to determine the clinical effectiveness of common treatment options for LET compared with no treatment or placebo. Clinical librarian searched (date 31 April 2022) for available systematic reviews and randomised controlled trials reviewing the management of the LET January 2011 onwards and evidence was collected and summarized using explicit GRADE criteria for rating the quality of evidence that include study design, risk of bias, imprecision, inconsistency, indirectness, and magnitude of effect. Recommendations were characterized as strong or weak (alternative terms conditional or discretionary) according to the quality of the supporting evidence and the balance between desirable and undesirable consequences of alternative management options. This informative summary provides the quality of available evidence for the management of LET.

Original languageEnglish
Pages (from-to)348-359
Number of pages12
JournalShoulder and Elbow
Issue number4
Early online date1 Aug 2023
Publication statusPublished - 1 Aug 2023


  • GRADE guidelines
  • patient care pathway
  • tennis elbow


Dive into the research topics of 'BESS patient care pathway: Tennis elbow'. Together they form a unique fingerprint.

Cite this