The road to consensus: lessons learned from FAIR and recommendations for future consensus activities

The consensus process, applied frequently in sport and exercise medicine (SEM), offers a structured framework to generate high-quality practical recommendations and/or identify research priorities to promote athlete health when robust clinical trial evidence is limited.Consensus activities integrate the best available evidence with the collective knowledge, experience and expertise of researchers and sport partners, including athletes, coaches, parents/carers, health and exercise practitioners, sport science and performance professionals, sport administrators and policy makers (also referred to as the athlete entourage, interest holders, knowledge users and consumers).To ensure transparency, repeatability and relevance, the ACCORD (accurate consensus reporting document) guidelines outline how to conduct and communicate consensus activities, and the British Journal of Sports Medicine also provides author guidelines for consensus statements. 1 Between April 2023 and September 2025, we conducted the female, woman and/or girl athlete injury prevention (FAIR) consensus, undertaking five systematic reviews, 2-6 a scoping review 7 and a concept mapping exercise.8 These activities informed the recommendations, which were discussed and voted on in a two-stage process, with 56 actionable final recommendations submitted for publication.9 While the FAIR consensus conduct and reporting aligned with the ACCORD guidelines, this editorial aims to summarise lessons learnt and recommendations to improve future consensus processes.1 LESSONS LEARNED AND SUGGESTIONS ON 'HOW TO' TO NAVIGATE THE ROAD TO CONSENSUSUndertaking a consensus activity the size of FAIR took about 2 years and approximately 100 volunteers.A smaller consensus activity may be quicker and require fewer resources.Regardless, there are critical considerations that can enhance the consensus process, which build on the ACCORD guidance table 1.