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Spinal cord independence measure evidence-based recommendation: a systematic review of measurement properties
Clarissa Volpato Sombrio Foschi1,2, Aline de Lima1,2, Stella Maris Michaelsen2
1Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.
Study Design:
Systematic Review (PROSPERO CRD42022297211).
Objectives:
To evaluate the measurement properties of Spinal Cord Independence Measure (SCIM) versions and to derive recommendations.
Methods:
We followed the COSMIN methodology for systematic reviews of Patient-Reported Outcome Measures (PROM) and adapted criteria for non-PROM to conduct the review and derive SCIM evidence-based recommendations. PubMed, CINAHL, EMBASE, Scopus and Lilacs databases were searched (November 2025). Studies reporting the development or evaluation of any SCIM measurement properties were included. We used the COSMIN Risk of Bias tool and the Criteria for Good Measurement Properties to critically appraise the studies and to summarise and rate the measurement properties. Evidence levels were established using a modified GRADE system.
Results:
The review included 50 articles, reporting five SCIM versions and 127 individual measurement property studies. The SCIM SR presented low-level evidence for sufficient content validity. The SCIM II, III, SR and IV presented high-level evidence for sufficient criterion validity and indeterminate structural validity. The SCIM III, SR and IV presented high-level evidence for sufficient internal consistency. The SCIM SR also presented high-level evidence for sufficient reliability. Moderate-level evidence for sufficient reliability was presented by SCIM II, III and IV, and for measurement error by SCIM III and SR.
Conclusions:
None of the SCIM versions fully fit all the COSMIN criteria for recommendation. The SCIM III, SR, and IV present the highest evidence levels for most measurement properties. Additionally, the SCIM SR meets the criteria for potential recommendation for having at least low-level evidence for sufficient content validity.
Sponsorship:
UDESC.
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