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Development and validation of a patient-reported checklist for dermatological complications in chronic spinal cord
Homayoon Khaledian1,2, Pantea Bozorg Savoji3, Ali Heidari Roochi1
1Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Study Design:
Cross-Sectional.
Objectives:
This study aimed to develop and conduct initial validation of a comprehensive, patient-reported checklist for identifying dermatological complications in individuals with chronic SCI.
Setting:
Sina Trauma and Surgery Research Center, Sina Hospital, Tehran, Iran.
Methods:
A multiphase, cross-sectional methodological study was conducted. The items were generated via a literature review and expert opinion, followed by content validation with a panel of 11 specialists via the content validity ratio (CVR) and content validity index (CVI). After face validation with patient representatives, the final checklist was field-tested in structured interviews with individuals from a national SCI registry. Interrater reliability was assessed with Cohen's kappa.
Results:
The final 16-item checklist demonstrated excellent content validity, with all the items meeting CVR thresholds and achieving high scale-level CVI scores (relevance=0.88, simplicity=0.92, clarity=0.89). Interrater reliability was excellent Cohen's kappa = 0.89). The tool was administered to 139 individuals with chronic SCI (mean age 43.9 years; 76.8% male), 44.6% (n = 62) of whom reported at least one complication. Among the 102 complications identified, those related to fungal infections (25.5%) and early-stage pressure injuries (20.6%) were the most prevalent. The mean onset time for the first complication was 2.7 months' post-injury.
Conclusions:
The Spinal Cord Injury Skin Complications Checklist (SCI-SCC) is a valid and reliable patient-reported tool for screening dermatological issues in this population. Its integration into routine clinical practice can facilitate standardized monitoring, promote early detection, and ultimately improve patient-centered care for individuals living with chronic SCI.
