A multistate framework for the analysis of subsequent injury in sport (M-FASIS)

I. Shrier, R. J. Steele, M. Zhao, A. Naimi, E. Verhagen, S. D. Stovitz, M. J. Rauh, Timothy Hewett

Research output: Contribution to journalReview article

15 Scopus citations


Physical activity is beneficial for many aspects of health but is associated with a risk of injury. Studies that assess causal risk factors of injury and reinjury provide valuable information to help develop and improve injury prevention programs. However, the underlying assumptions of analytical approaches often used to estimate causal factors in injury and subsequent injury research are often violated. This means that ineffective or even harmful interventions could be proposed because the underlying analyses produced unreliable or invalid causal effect estimates. We describe an adapted version of the multistate framework [multistate framework for the analysis of subsequent injury in sport (M-FASIS)] that makes investigator choices more transparent with respect to outcome and healing time. In addition, M-FASIS incorporates all previous sport injury analytical frameworks and accounts for injuries or conditions that heal or do not heal to 100%, acute and overuse injuries, illnesses, and competing event outcomes.

Original languageEnglish (US)
Pages (from-to)128-139
Number of pages12
JournalScandinavian Journal of Medicine and Science in Sports
Issue number2
StatePublished - Feb 1 2016
Externally publishedYes



  • Injury
  • Methods
  • Statistics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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