Enabling knowledge translation: implementation of a web-based tool for independent walking prediction after traumatic spinal cord injury

Frontiers in Neurology, 2023 · DOI: 10.3389/fneur.2023.1219307 · Published: December 5, 2023

Simple Explanation

Clinical prediction rules (CPRs) can help clinicians make better decisions, but many are not easily accessible. This study describes the creation of a web-based CPR called 'Ambulation' to predict if someone with a traumatic spinal cord injury (TSCI) will be able to walk independently one year after their injury. Ambulation uses a validated CPR and was built with input from clinicians, researchers, and people with lived experience of SCI. It was designed to be user-friendly and provide quick predictions to assist in clinical decision-making, patient education, and goal setting. The website had five pages: Home, Calculation, Team, Contact, and Privacy Policy. After its release, the website was used by almost 600 people, mainly from the United States and Canada, demonstrating the potential of web-based tools to translate research into clinical practice.

Study Duration

February 7, 2022 to February 28, 2023

Participants

30 clinicians (surgeons, physiatrists, and physiotherapists) for pilot, 594 total users of the website

Evidence Level

Not specified

Key Findings

1
Ambulation, a web-based calculator for predicting independent walking ability after TSCI, was successfully developed and launched.
2
User feedback indicated that Ambulation was easy to navigate, use, and understand, with most respondents preferring to use it on a desktop PC or MacBook.
3
Website analytics showed a steady increase in new users over time, with peaks coinciding with presentations at conferences. A significant portion of users clicked the re-calculate button multiple times, suggesting the CPR's ongoing utility.

Research Summary

The study aimed to develop and implement a web-based clinical prediction rule (CPR) called Ambulation for predicting independent walking one year after traumatic spinal cord injury (TSCI). Ambulation was co-designed with clinicians, researchers, and individuals with lived experience, and it underwent 11 revisions to improve usability and clarity. The final version consisted of five web pages and incorporated a simplified CPR by Hicks et al. The pilot launch and subsequent data analysis demonstrated that Ambulation gained steady traction among users, particularly in the United States and Canada, and that users found the tool easy to use and helpful for clinical decision-making and discharge planning.

Practical Implications

Clinical Decision-Making

Ambulation can assist clinicians in making informed decisions regarding patient care, such as determining the appropriate time for surgery or developing a rehabilitation plan.

Patient Education and Goal Setting

The tool can be used to educate patients about their prognosis and help them set realistic goals for recovery.

Knowledge Translation

The study provides a model for translating research findings into a practical, user-friendly tool that can be easily adopted into clinical practice.

Study Limitations

1
Low response rate to the feedback survey.
2
Test users were limited to clinicians in Canada.
3
The clinical utility of Ambulation is limited to the setting and populations in which the CPR by Hicks et al. was developed and validated

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury