Do we need to adjust exposure to account for the proportion of a cohort consenting to injury surveillance in team sports?

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Abstract
Voluntary informed consent is key when undertaking research with an opt-in rather than opt-out system in place and is typically required to legally comply with data protection and processing regulations (eg, General Data Protection Regulation in Europe).5 This can pose challenges to sports injury epidemiology where data may be recorded for internal medical purposes, but not all data can and or should be used for research purposes. Consent can be obtained in different ways, such as consent for sharing data for research purposes when athletes sign contracts with a club or project-specific consent whereby the research team seek consent directly from athletes. It is likely that sports injury epidemiology studies use different methods based on country-specific data laws, how data are collected and the partnerships in place conducting the research. Regardless, published sports injury epidemiology research states consent was obtained from athletes (eg,6 7); however, many studies do not report the proportion of consent within the cohort. For example, in a squad of 50 athletes, how many will provide voluntary informed consent? When an athlete does not grant consent, their injuries will not be included in the numerator part of injury incidence (eg, number of injuries in a squad during a season). However, understanding how many of the cohort provide consent is important for calculating the denominator (exposure) in time-based injury incidence.

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