Validation of MENTOR Tool to Describe Bowel Dysfunction in Inpatient Rehabilitation Setting

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Decision Support

Background:

• Neurogenic bowel dysfunction (NBD) is a major challenge for individuals with spinal cord injury (SCI).
• No validated clinical decision-making tool currently exists for NBD management during the acute/subacute phase post-SCI.
• The Monitoring Efficacy of NBD Treatment On Response (MENTOR) tool was previously developed for chronic SCI bowel management.

Purpose of the Study:

• To evaluate the validity of the MENTOR tool for NBD management in the acute/subacute SCI setting.

Main Methods:

• The MENTOR tool was administered via interview before discharge from inpatient rehabilitation.
• A study clinician, masked to MENTOR results, performed an immediate clinical evaluation.
• Concordance was assessed using percent agreement between MENTOR recommendations and clinical evaluations.

Main Results:

• 240 participants were enrolled, with demographic and clinical variations noted.
• Overall concordance between MENTOR and clinical recommendations was 40.6%.
• The most frequent clinician evaluation, irrespective of MENTOR results or other factors, was 'no change'.

Conclusions:

• The MENTOR tool did not demonstrate similar concordance in the acute/subacute SCI population compared to the chronic population.
• The MENTOR tool might be valuable as a screening instrument to identify individuals requiring further clinical assessment.