CSSD Ethical Practices & Evidence-Based Guidelines 3 — Questions and Answers
Question 1: A CSSD discovers a colleague is recommending unapproved ergogenic aids with false efficacy claims to athletes. The most appropriate initial step is to:
- Report directly to CDR without speaking to the colleague
- Address the issue with the colleague directly first, then escalate if unresolved (Correct answer)
- Ignore it as it does not involve your clients
- Inform athletes directly and advise them to switch practitioners
Correct answer: Address the issue with the colleague directly first, then escalate if unresolved
CDR's Code of Ethics encourages addressing ethical violations collegially first before escalating to formal reporting bodies.
Question 2: Meta-analyses of nutrition studies can be limited by 'publication bias,' which means:
- Studies are published too quickly without peer review
- Positive or significant results are more likely to be published than null results (Correct answer)
- Meta-analyses only include government-funded studies
- Researchers publish duplicate data across multiple journals
Correct answer: Positive or significant results are more likely to be published than null results
Publication bias inflates perceived intervention effectiveness because studies showing no effect are less likely to reach publication.
Question 3: An athlete asks a CSSD about a supplement trending on social media with no peer-reviewed research. The CSSD should:
- Recommend it if no adverse effects are reported online
- Advise against it until adequate evidence supports safety and efficacy (Correct answer)
- Suggest a trial period of four weeks and monitor self-reported outcomes
- Defer the decision entirely to the athlete's personal preference
Correct answer: Advise against it until adequate evidence supports safety and efficacy
Absence of documented harm is not sufficient justification; evidence of safety and efficacy must exist before recommendation.
Question 4: A CSSD's client is a minor athlete whose parents request nutrition information that the athlete has asked to keep private. The practitioner should:
- Share all information with parents since parents hold legal consent
- Withhold all information from parents regardless of circumstances
- Evaluate age, maturity, and legal requirements while working to include both athlete and parents appropriately (Correct answer)
- Terminate services to avoid the ethical conflict
Correct answer: Evaluate age, maturity, and legal requirements while working to include both athlete and parents appropriately
Working with minor athletes requires balancing parental rights, the athlete's developing autonomy, and applicable legal standards.
Question 5: The ISSN (International Society of Sports Nutrition) position stands are best characterized as:
- Regulatory mandates dietitians must follow
- Expert consensus documents graded by evidence level (Correct answer)
- Industry-sponsored marketing guidelines
- Preliminary findings not yet suitable for clinical use
Correct answer: Expert consensus documents graded by evidence level
ISSN position stands are evidence-graded consensus documents created by sports nutrition experts for clinical and research guidance.
Question 6: Which scenario represents a dual-role conflict of interest for a CSSD?
- Treating athletes from multiple sports on the same team
- Serving as both team dietitian and paid consultant for a supplement brand supplying the team (Correct answer)
- Providing services to recreational and elite athletes simultaneously
- Working in both clinical and private practice settings
Correct answer: Serving as both team dietitian and paid consultant for a supplement brand supplying the team
Simultaneously advising a team and receiving financial benefit from a supplement supplier creates a conflict of interest that compromises objective counsel.
Question 7: When integrating evidence into practice, the evidence-based practice (EBP) triad requires consideration of:
- Cost, convenience, and client preference only
- Best research evidence, clinical expertise, and client values/preferences (Correct answer)
- Randomized trials, systematic reviews, and meta-analyses exclusively
- Regulatory guidance, national standards, and insurance coverage
Correct answer: Best research evidence, clinical expertise, and client values/preferences
EBP integrates the best available research with practitioner expertise and individual client context and values.
CSSD Ethical Practices & Evidence-Based Guidelines 3
A CSSD discovers a colleague is recommending unapproved ergogenic aids with false efficacy claims to athletes.
The most appropriate initial step is to: