Accuracy of self-reported severity and level of spinal cord injury

Spinal Cord, 2022 · DOI: https://doi.org/10.1038/s41393-022-00855-1 · Published: September 12, 2022

Spinal Cord Injury Neurology Research Methodology & Design

Simple Explanation

This study aimed to evaluate how accurately individuals with spinal cord injuries (SCI) can self-report their injury level and severity compared to clinical examinations. The researchers compared self-reported data with clinical assessments and initial injury information from medical charts to determine the accuracy of self-reporting. The results showed that individuals are more accurate in reporting the general region of their injury than the specific level. Also, self-reported information tends to align more with initial clinical assessments than current ones.

Study Duration

January to October 2020

Participants

28 individuals with chronic spinal cord injury

Evidence Level

Observational

Key Findings

1
Ninety-three percent of participants correctly self-reported the anatomical region of their injury.
2
Only 25% of participants self-reported the same specific level of injury as their current clinical assessment, but 61% matched their initial injury level.
3
A decision tree algorithm, using responses to multiple questions, was 75% accurate in categorizing injury severity, improving to 79% with additional questions about S1 sparing.

Research Summary

The study assessed the accuracy of self-reported injury level and severity in individuals with chronic SCI compared to clinical examination findings. Participants were more accurate in reporting the region of injury than the specific level, and self-reported data aligned more closely with initial clinical results. A decision tree algorithm improved the accuracy of injury severity classification based on self-reported data.

Practical Implications

Improved Survey Design

Utilizing aggregate data from multiple questions in surveys can enhance the reliability of injury severity classification.

Telehealth Applications

Self-report methods can be valuable for data gathering from large groups and individuals without access to SCI specialists.

Clinical Practice Insights

Understanding the tendency for self-reported data to align with initial assessments can inform patient education and clinical communication.

Study Limitations

1
The study used a convenience sample from a single SCI Model System hospital, limiting generalizability.
2
There was no guidance in the questionnaire as to whether participants were to report anatomical or neurologic level of injury.
3
ISNCSCI exams abstracted from inpatient records were completed by various clinicians, potentially affecting consistency.

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