Evidence map›Paper›PMID 28631745›Full record

Trial reportSpinal cord2017

Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury.

A J Armstrong, J M Clark, D T Ho, C J Payne, S Nolan, L M Goodes, L A Harvey, R Marshall, M P Galea, S A Dunlop

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Spinal cord, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

A J ArmstrongFaculty of Medicine, Dentistry and Health Science, The University of Western Australia, Crawley, Western Australia, Australia.
J M ClarkSouth Australian Spinal Cord Injury Research Centre, Centre for Orthopedics and Trauma Research, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
D T HoFaculty of Medicine, Dentistry and Health Science, The University of Western Australia, Crawley, Western Australia, Australia.
C J PayneFaculty of Medicine, Dentistry and Health Science, The University of Western Australia, Crawley, Western Australia, Australia.
S NolanSchool of Biological Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
L M GoodesSchool of Biological Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
L A HarveyJohn Walsh Centre for Rehabilitation Research, Sydney School of Medicine, University of Sydney & Kolling Institute, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
R MarshallSouth Australian Spinal Cord Injury Research Centre, Centre for Orthopedics and Trauma Research, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
M P GaleaDepartment of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia.
S A DunlopSchool of Biological Sciences, The University of Western Australia, Crawley, Western Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designA retrospective audit of assessor accuracy using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in three multicentre randomised controlled trials (SCIPA: Spinal Cord Injury and Physical Activity) spanning 2010-2014 with standards revised in 2011.

objectivesTo investigate assessor accuracy of neurological classification after spinal cord injury.

settingAustralia and New Zealand.

methodsISNCSCI examinations were undertaken by trained clinicians prior to randomisation. Data were recorded manually and ISNCSCI worksheets circulated to panels, consensus reached and worksheets corrected. An audit team used a 2014 computerised ISNCSCI algorithm to check manual worksheets. A second audit team assessed whether the 2014 computerised algorithm accurately reflected pre- and post-2011 ISNCSCI standards.

resultsOf the 208 ISNCSCI worksheets, 24 were excluded. Of the remaining 184 worksheets, 47 (25.5%) were consistent with the 2014 computerised algorithm and 137 (74.5%) contained one or more errors. Errors were in motor (30.1%) or sensory (12.4%) levels, zone of partial preservation (24.0%), motor/sensory scoring (21.5%), ASIA Impairment Scale (AIS, 8.3%) and complete/incomplete classification (0.8%). Other difficulties included classification when anal contraction/sensation was omitted, incorrect neurological levels and violation of the 'motor follows sensory rule in non-testable myotomes' (7.4%). Panel errors comprised corrections that were incorrect or missed or incorrect changes to correct worksheets.

conclusionGiven inaccuracies in the manual ISNCSCI worksheets in this long-term clinical trial setting, continued training and a computerised algorithm are essential to ensure accurate scoring, scaling and classification of the ISNCSCI and confidence in clinical trials.

Indexed as

AlgorithmsAustraliaHumansMedical AuditNeurologic ExaminationNew ZealandRetrospective StudiesSpinal Cord Injuries

Identifiers

PMID28631745

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.