Accelerating diagnosis of degenerative cervical myelopathy through improved education: a mixed-methods study protocol from Myelopathy.org RECODE-DCM to define stakeholders, knowledge requirements and an optimal intervention strategy

INTRODUCTION: Outcomes for degenerative cervical myelopathy (DCM) patients are limited by delayed and missed diagnoses, driven in part by poor professional awareness. Despite DCM being the most common cause of adult spinal cord injury, it remains under-recognised and undertaught in clinical education. Lessons from other common pathology like stroke and acute myocardial infarction highlight the potential of education to improve early diagnosis. This study will develop a professional education strategy to improve early DCM diagnosis. It will define key audiences and identify an effective delivery method, laying the groundwork for a sustained, targeted intervention. METHODS AND ANALYSIS: The study aims to define who needs to know about DCM, what they need to know and how they can learn it. This will be carried out in three phases: phase 1-who and what: to establish the target population and to define core competencies for the educational intervention; phase 2-how: to create and review the educational intervention; phase 3-evaluation: to test whether the framework is an improvement to existing strategies. ETHICS AND DISSEMINATION: Ethical approval is in place from the University of Cambridge (HBREC.2024.24). Results from the study will be disseminated through scientific publication, conference presentation, blog posts and podcasts. PROSPERO REGISTRATION NUMBER: CRD42023461838.