BackgroundOveruse injuries are reported to be more common than acute trauma in children and adolescents, causing pain and reduced function. The most common is apophysitis - a traction injury to the apophysis in growing individuals. The duration of symptoms reported in the literature is between 6 weeks to 6 months or more. The objective of this systematic review and network meta-analysis is to compare the effectiveness and safety of all available treatments for any type of apophysitis in children and adolescents.Methods/DesignWe will conduct a systematic review to retrieve all relevant studies applying a comparative design. Searches will be made in the Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and SportDiscus databases and via reference searching. The efficacy of treatments will be compared with respect to the outcomes 1) time to pain-free activity and 2) risk of subsequent injury. Risk of bias assessment will be made using revised tool for assessing risk of bias in randomized trials for Randomized trials and Robins-I tool for non-randomized trials. We will explore if different treatment comparisons are sufficiently similar in terms of effect modifiers (transitivity assumption) with the aim to conduct network meta-analyses for randomized and non-randomized studies separately. A treatment hierarchy will be obtained using the surface under the cumulative ranking curve (SUCRA) and mean ranks, visualized using rankograms. We will use the CINeMA software to apply the modified version of Grades of Recommendation, Assessment, Development and Evaluation (GRADE), developed specifically to evaluate the quality of evidence in network meta-analysis.DiscussionTo date the comparative effects of interventions for apophysitis seem to rely mainly on expert opinion. We aim to identify all comparative treatment designs described in the literature and synthesize data when possible. We will use the estimated treatment effects between injury locations to provide guidance in managing apophysitis.Trial registrationPROSPERO ID number: CRD42018083746.Electronic supplementary materialThe online version of this article (10.1186/s12998-018-0209-8) contains supplementary material, which is available to authorized users.

Introduction QUALIDEM is a dementia‐specific QoL instrument that allows a proxy‐based Quality of Life rating in all stages of dementia. It was originally developed in The Netherlands and has later been translated into English and German. This study endeavoured to translate, cross‐culturally adapt and test important psychometric properties of a Danish version in a cross‐sectional validation study with a nested test–retest design. Method All items underwent forward and backward translation by bilingual academics. Persons with dementia were recruited from 28 healthcare units in a Danish municipality. The severity of dementia was determined using a pragmatic approach allowing the site team to trichotomise the disease (mild, moderate–severe and very severe) before scoring the QUALIDEM. Psychometric properties for QUALIDEM were determined for item characteristics, construct validity, internal consistency, test–retest reliability, measurement error and floor and ceiling effects. The study was approved by The Danish Data Protection Agency. Results A total of 169 persons with dementia, aged 51–103, were included. The construct validity testing showed that the overall proportion of correctly hypothesised correlations was 83%. Testing for internal consistency, Cronbach's α ranged from 0.65 to 0.85 in mild–severe dementia with three out of nine subscales having values below 0.7. For very severe dementia, Cronbach's α ranged from 0.44 to 0.81, with three out of six subscales having insufficient values. For test–retest reliability, the intra‐class correlation coefficients ranged from 0.56 to 0.86. The ‘scale width’ method revealed a marked ceiling effect in all subscales ranging from 30.6% to 87.7%. Discussion The QUALIDEM was successfully translated and cross‐culturally adapted into Danish. Most subscales show acceptable internal consistency and test–retest reliability. However, a substantial measurement error and ceiling effect was present in most subscales. Conclusion With few exceptions, the subscales of the Danish version of QUALIDEM have acceptable validity and reliability. Future research should address the limitations of the ceiling effects.