BACKGROUND: There is no valid and reliable instrument that evaluates injury severity and treatment effects for medial tibial stress syndrome (MTSS) patients. OBJECTIVE: The aim was to generate items for the MTSS score, a new patient-reported outcome measure for patients with MTSS. METHODS: The authors consulted experts in the fi eld of MTSS to generate items that measure the severity of MTSS and to reach consensus on the relevance of items for the MTSS score. This research consisted of a pilot study and two Delphi rounds. The Delphi approach entails the consultation of experts about a topic for which no evidence is available during which consensus is sought on this topic. Additionally, 20 MTSS patients appraised the MTSS score on readability and comprehension. RESULTS: Nineteen experts consented to participate, 13 of whom reached consensus. Generated items address the following domains: 'limitation in sporting activities', 'pain while performing sporting activities', 'pain while performing activities of daily living' and 'pain at rest. Patients with MTSS confirmed the good readability and comprehension of the items. CONCLUSION: This study supports the importance of items in the aforementioned domains while evaluating treatment effects in atients with MTSS.

The main objective of the present study was to assess the specificity and sensitivity of a modified assay using short synthetic peptides of the V3 region of HIV-1 gp120, which is the main target for neutralizing antibodies. Results from an enzyme immunoassay (EIA) employing a panel of synthetic peptides of HIV-1 subtypes and using urea washes to detect high avidity antibodies (AAV3) were compared with those obtained by the heteroduplex mobility assay and DNA sequencing. The EIA correctly typed 100% of subtype B (sensitivity = 1.0; specificity = 0.95), 100% of HIV-1 E samples (sensitivity = 1.0; specificity = 1.0), and 95% of subtype C specimens (sensitivity = 0.95; specificity = 0.94). In contrast, only 50% of subtype A (sensitivity = 0.5; specificity = 0.95), 60% of subtype D (sensitivity = 0.6; specificity = 1.0), and 28% of subtype F samples (sensitivity = 0.28; specificity = 0.95) were correctly identified. This approach was also able to discriminate in a few samples antibodies from patients infected with B variants circulating in Brazil and Thailand that reacted specifically. The assays described in this study are relatively rapid and simple to perform compared to molecular approaches and can be used to screen large numbers of serum or plasma samples. Moreover, the classification in subtypes (genotypes) may overestimate HIV-1 diversity and a classification into serotypes, based on antigenic V3 diversity or another principal neutralization domain, may be more helpful for vaccine development and identification of variants.