Inter-Rater Reliability of the International Standards to Document Remaining Autonomic Function after Spinal Cord...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Assessment

Background:

• Autonomic nervous system dysfunction is common and significantly impacts quality of life after spinal cord injury (SCI).
• Systematic clinical assessment of autonomic function post-SCI is often lacking.
• The International Standards to Document Remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) assessment tool was developed to address this gap.

Purpose of the Study:

• To evaluate the psychometric properties of the ISAFSCI, specifically its inter-rater reliability.
• To determine the consistency of ISAFSCI results when administered by different assessors.

Main Methods:

• The study included 48 participants with chronic traumatic SCI (over 1 year post-injury).
• Assessors used a standardized protocol to administer the ISNCSCI and ISAFSCI assessments.
• Inter-rater reliability was calculated using percentage agreement, kappa, and weighted kappa statistics over a 10-14 day interval.

Main Results:

• Moderate inter-rater reliability (kappa 0.41-0.6) was found for the general autonomic component of the ISAFSCI.
• Good to strong inter-rater reliability (weighted kappa 0.62-0.88) was observed for the Lower Urinary Tract, Bowel, and Sexual Function component.
• The ISAFSCI demonstrated acceptable reliability across different assessors.

Conclusions:

• The ISAFSCI assessment tool exhibits at least moderate, and up to strong, inter-rater reliability.
• The ISAFSCI is a reliable tool for assessing autonomic function, particularly for bladder, bowel, and sexual function, in individuals with SCI.
• These findings support the use of ISAFSCI in clinical settings for standardized autonomic function evaluation post-SCI.