The International Standards for Neurological Classification of Spinal Cord Injury: Classification Accuracy and Challenges.

Successful utilization of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) requires a comprehensive understanding of its rules, terminology, and several complex concepts. There have been no studies investigating classification accuracy since the newest ISNC...

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Published in:Topics in Spinal Cord Injury Rehabilitation Vol. 29; no. 1; pp. 1 - 16
Main Authors: Snider, Brittany A., Eren, Fatma, Reeves, Ronald K., Rupp, Rüdiger, Kirshblum, Steven C.
Format: research tables/charts Journal Article
Published: KnowledgeWorks Global, Ltd Winter2023
Online Access:View this record in EBSCOhost
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      dt: Winter2023
      vid: 29
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        10.46292/sci22-00036
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        atl: The International Standards for Neurological Classification of Spinal Cord Injury: Classification Accuracy and Challenges.
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        au:
          Snider, Brittany A.
          Eren, Fatma
          Reeves, Ronald K.
          Rupp, Rüdiger
          Kirshblum, Steven C.
        affil: Kessler Institute for Rehabilitation, West Orange, New Jersey
      sug:
        subj:
          Spinal Cord Injuries Classification
          Neurologic Examination Standards
          International Agencies
          Spinal Cord Injuries Organizations
          Human
          United States
          Questionnaires
          Descriptive Statistics
          Data Analysis Software
          Kruskal-Wallis Test
          One-Way Analysis of Variance
          Mann-Whitney U Test
          Sensation
      ab: Successful utilization of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) requires a comprehensive understanding of its rules, terminology, and several complex concepts. There have been no studies investigating classification accuracy since the newest ISNCSCI revision (2019). To evaluate classification accuracy of SCI professionals using the 2019 ISNCSCI edition, identify common mistakes and areas of confusion, and assess associations between experience in ISNCSCI classification and performance. Members of the International Spinal Cord Society (ISCoS) and attendees of the ISCoS Annual Scientific Meeting 2021 were invited to complete an online survey that included six ISNCSCI cases to classify. A total of 107 persons completed the survey, with overall classification accuracy of 74.6%. Accuracy was highest for injury completeness (95.3%) and sensory level (91.1%) and lowest for motor zone of partial preservation (ZPP; 54.7%) and ASIA Impairment Scale (AIS) grade (57.3%). Newer concepts, including the appropriate documentation of non-SCI conditions and classification of ZPP in incomplete injuries, contributed to several common errors. There was a significant association between overall classification accuracy and self-rated experience in the ISNCSCI classification (p =.017). Experience with the ISNCSCI examination, experience in SCI medicine, and occupation were not found to be significantly associated with overall classification accuracy. Classification accuracy of an international cohort of SCI professionals was modest but greater than previous reports. Knowledge deficits about the 2019 ISNCSCI updates are prevalent and contribute to common classification errors. Further training in the utilization of the ISNCSCI is needed.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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