Computerized classification of neurologic injury based on the international standards for classification of spinal...

To develop and test a computer program to accurately score International Standards for Classification of Spinal Cord Injury (ISCSCI) examinations.

A computer program was written following the algorithm published in the ISCSCI 2003 manual. Two methods were used to test the computer program's accuracy. First, 94 hand-scored examinations representing 25 different patients were entered into the program. Differences between hand-scored examinations and computer-scored examinations were evaluated for accuracy. Second, all case examples from the ISCSCI manual were entered into the computer program to verify its accuracy.

Of the 94 hand-scored examinations, the computer detected all incorrectly scored examinations. Furthermore, the computer scoring agreed with every examination's scores that were correctly calculated by hand. Of the hand-scored examinations, 10% of sensory total scores and 4% of motor scores were incorrect. For sensory level and motor level, there were errors in 9% and 26% of hand-scored examinations, respectively; 13% of hand-scored examinations had incorrectly assigned ASIA Impairment Scale classification.

This study showed that the computer program we developed was effective in correctly scoring ISCSCI examinations and was able to detect errors in hand-scored examinations.