International standards for neurological classification of spinal cord injury: classification skills of clinicians versus computational algorithms.
Study design:This is a retrospective analysis.Objectives:The objective of this study was to describe and quantify the discrepancy in the classification of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) by clinicians versus a validated computational algori...
| Publicado en: | Spinal Cord Vol. 53; no. 4; pp. 324 - 332 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103786788&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103786788 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13624393 DZQ jtl: Spinal Cord issn: 13624393 maglogo: Y pubinfo: dt: Apr2015 vid: 53 iid: 4 pid: 2579 pub: Springer Nature place: Dordrecht, <Blank> artinfo: ui: 103786788 102007551 10.1038/sc.2014.221 NLM25487243 103786788 ppf: 324 ppct: 8 formats: tig: atl: International standards for neurological classification of spinal cord injury: classification skills of clinicians versus computational algorithms. aug: au: Schuld, C Franz, S van Hedel, H J A Moosburger, J Maier, D Abel, R van de Meent, H Curt, A Weidner, N Rupp, R affil: Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany sug: subj: Spinal Cord Injuries Classification Human Retrospective Design Quantitative Studies Algorithms Expert Clinicians Multicenter Studies Switzerland France Germany Netherlands Minimum Data Set Physicians Interns and Residents Funding Source ab: Study design:This is a retrospective analysis.Objectives:The objective of this study was to describe and quantify the discrepancy in the classification of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) by clinicians versus a validated computational algorithm.Settings:European Multicenter Study on Human Spinal Cord Injury (EMSCI).Methods:Fully documented ISNCSCI data sets from EMSCI's first years (2003-2005) classified by clinicians (mostly spinal cord medicine residents, who received in-house ISNCSCI training by senior SCI physicians) were computationally reclassified. Any differences in the scoring of sensory and motor levels, American Spinal Injury Association Impairment Scale (AIS) or the zone of partial preservation (ZPP) were quantified.Results:Four hundred and twenty ISNCSCI data sets were evaluated. The lowest agreement was found in motor levels (right: 62.1%, P=0.002; left: 61.8%, P=0.003), followed by motor ZPP (right: 81.6%, P=0.74; left 80.0%, P=0.27) and then AIS (83.4%, P=0.001). Sensory levels and sensory ZPP showed the best concordance (right sensory level: 90.8%, P=0.66; left sensory level: 90.0%, P=0.30; right sensory ZPP: 91.0%, P=0.18; left sensory ZPP: 92.2%, P=0.03). AIS B was most often misinterpreted as AIS C and vice versa (AIS B as C: 29.4% and AIS C as B: 38.6%).Conclusion:Most difficult classification tasks were the correct determination of motor levels and the differentiation between AIS B and AIS C/D. These issues should be addressed in upcoming ISNCSCI revisions. Training is strongly recommended to improve classification skills for clinical practice, as well as for clinical investigators conducting spinal cord studies.Sponsorship:This study is partially funded by the International Foundation for Research in Paraplegia, Zurich, Switzerland. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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