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The diagnostic accuracy of self-report for determining S4-5 sensory and motor function in people with spinal cord
L A Harvey1, G Weber, R Heriseanu
1Rehabilitation Studies Unit, Northern Clinical School, Sydney School of Medicine, University of Sydney, Sydney, New South Wales, Australia. l.harvey@usyd.edu.au
Study Design:
A diagnostic accuracy study.
Objectives:
The objective was to determine the ability of people with SCI to accurately self-report S4-5 sensory and motor function.
Setting:
Outpatient clinic, Sydney, Australia.
Methods:
A consecutive series of thirty-four people who had sustained a SCI more than 1 year before the study, and who were attending an outpatient medical clinic were recruited. They were assessed on two occasions. On the first occasion, ability to self-report S4-5 sensory and motor function was assessed with four questions. On the second occasion, a rehabilitation physician performed a physical examination to determine participants' S4-5 sensory and motor function. The rehabilitation physician was unaware of the results of participants' self-report. Participants' self-reports were compared with results from the physical examination using likelihood ratios.
Results:
The likelihood ratios (95% CI) associated with a positive response to the sensory and motor questions were 1.92 (1.0-3.6) and 2.4 (1.2-4.9), respectively. The likelihood ratios associated with a negative response to the sensory and motor questions were 0.1 (0.0-0.6) and 0.4 (0.1-1.2), respectively.
Conclusion:
People with SCI are reasonably accurate at self-reporting S4-5 sensory and motor function, although there is a high rate of false positives for S4-5 motor in those with motor levels below T10. In some situations it may be appropriate to use self-report rather than a physical examination to determine S4-5 sensory and motor function.
