Active Voice: Position Stand Development at ACSM

By Lynette L. Craft, Ph.D., FACSM

ACSM has a long history of publishing position stand documents. The position stand is the most authoritative, evidence based statement issued by ACSM. The topics covered by these documents represent those deemed to be among the most important and contemporary for ACSM to address in sports medicine and exercise science.

ACSM Position Stands are designed to:

  • Answer specific scientific and/or clinical question(s);
  • Provide overall summaries of the literature and strength of the cumulative evidence, as of the date that the document has been issued;
  • Provide evidence based recommendations to support decision-making; and
  • Identify gaps in knowledge that can serve the purpose of stimulating and advancing further scientific activity that may advance the knowledge base.
  • Over the past few years, ACSM has devoted significant resources to the creation of a protocol for the development of position stands that will ensure that the contents reflect the best available science, and that the process is systematic, transparent and efficient. To that end, position stands are written per processes outlined in ACSM’s Evidence Based Protocol for Position Stand Development. This protocol statement includes identification and approval of PICO questions, a systematic review of the literature, evaluation of individual studies for freedom from risk of bias and grading the strength of the overall body of evidence. PICO refers to a paradigm for extracting answers from the health sciences literature, e.g. Population, Intervention, Control, Outcome. The position stand also undergoes multiple rounds of external peer review and internal organizational review prior to being approved by the board of trustees as an official pronouncement of ACSM and published in Medicine & Science in Sports & Exercise®

    In 2013, the college approved and adopted this new protocol and, in 2016, two position stands were published using this new methodology. These include:

    1. Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review and;
    2. Nutrition and Athletic Performance (this is a joint position stand with the Academy for Nutrition and Dietetics and the Dietitians of Canada).

    Currently, one other is underway, i.e. an update to the 2004 Exercise and Hypertension Position Stand. Following completion and approval of that document, the 2007 Position Stand on Exertional Heat Illness during Training and Competition will be updated. 

    In addition to the new protocol, the college has created the MOSAIC Resource Center and Evidence Library. MOSAIC is envisioned as both a repository for a variety of resources that members can use in their teaching, research and clinical work, as well as a repository for the work done by ACSM Credentialed Evidence Analysts, as they contribute to the creation of position stands. Credentialed evidence analysts are volunteer ACSM members who have completed the evidence analyst training webinar and credentialing exercises. The credentialed evidence analysts assist with the development of ACSM position stands by reviewing, summarizing and grading the research included in position stands. The work of each analyst is documented and maintained in MOSAIC for transparency, efficiency and for use by the position stand writing group. In the future, readers of the position stand will be able to access MOSAIC to see how the individual studies used to develop the position stand were summarized and graded. Longer term, the position stand becomes a living document, with periodic updates scheduled at appropriate points that will include previous work housed in MOSAIC, as well as results of analyses completed on new scientific literature accumulated since the position stand was last published. 

    Click here to view a flow chart that outlines the key steps in the development of position stands.

    Lynette L. Craft, Ph.D., FACSM, is the vice president for evidence based practice and scientific affairs at ACSM. 

    Dr. Craft earned her Ph.D. in kinesiology and is an adjunct faculty member in the Department of Preventive Medicine at Northwestern University, Feinberg School of Medicine in Chicago, Illinois where her research focused on the relationship between exercise and mental health. In her role as VP at ACSM, she provides expertise and oversight to ensure that evidence based practice protocols and processes are followed when developing and disseminating ACSM’s official pronouncements. In this capacity, she works with expert panels in all phases of developing ACSM Position Stands, which are systematic evidence based reviews that lead to major findings. In addition, she is leading the development of MOSAIC, an online resource center and evidence library for sports medicine and the exercise sciences. 

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