title: Expert consensus statement to guide the evidence-based classification of Paralympic athletes with vision impairment: a Delphi study.
abstract: BACKGROUND
  Paralympic sports are required to develop evidence-based systems that allocate athletes into 'classes' on the basis of the impact of their impairment on sport performance. However, sports for athletes with vision impairment (VI) classify athletes solely based on the WHO criteria for low vision and blindness. One key barrier to evidence-based classification is the absence of guidance on how to address classification issues unique to VI sport. The aim of this study was to reach expert consensus on how issues specific to VI sport should be addressed in evidence-based classification.
  
  
  METHODS
  A four-round Delphi study was conducted with 25 participants who had expertise as a coach, athlete, classifier and/or administrator in Paralympic sport for VI athletes.
  
  
  RESULTS
  The experts agreed that the current method of classification does not fulfil the requirements of Paralympic classification, and that the system should be different for each sport to account for the sports' unique visual demands. Instead of relying only on tests of visual acuity and visual field, the panel agreed that additional tests are required to better account for the impact of impairment on sport performance. There was strong agreement that all athletes should not be required to wear a blindfold as a means of equalising the impairment during competition.
  
  
  CONCLUSIONS
  There is strong support within the Paralympic movement to change the way that VI athletes are classified. This consensus statement provides clear guidance on how the most important issues specific to VI should be addressed, removing key barriers to the development of evidence-based classification.
authors.affiliation: Faculty of Human Movement Sciences, Faculty of Behavioural and Movement Sciences Research Institute MOVE Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: H J C Rianne
authors.initials: HJ
authors.lastname: Ravensbergen
authors.affiliation: Faculty of Human Movement Sciences, Faculty of Behavioural and Movement Sciences Research Institute MOVE Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: D L
authors.initials: DL
authors.lastname: Mann
authors.affiliation: Musculoskeletal Division, The George Institute, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kamper
mesh_terms: D056352:Athletes / Q000145:classification*; D032921:Consensus; D003697:Delphi Technique; D006233:Persons with Disabilities / Q000145:classification*; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D013177:Sports / Q000592:standards*; D014786:Vision Disorders / Q000145:classification* / Q000175:diagnosis
keywords: Disability; Evidence based; Sport; Vision