Catz Amiram, Itzkovich Malka, Elkayam Keren, Michaeli Dianne, Gelernter Ilana, Benjamini Yoav, Chhabra Harvinder Singh, Tesio Luigi, Engel-Haber Einat, Bizzarini Emiliana, Pilati Claudio, Del Popolo Giulio, Baroncini Ilaria, Liu Nan, Margalho Paulo, Soeira Thabata Pasquini, Chandy Bobeena, Joshi Mrinal, Lemay Jean-Francois, Curran Dorothyann, Leiulfsrud Annelie Schedin, Sørensen Linda, Biering-Sorensen Fin, Kesiktas Nur, Osman Aheed, Bluvshtein Vadim
Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arch Phys Med Rehabil. 2022 Mar;103(3):430-440.e1. doi: 10.1016/j.apmr.2021.07.811. Epub 2021 Oct 20.
To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity.
Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations.
A multicultural cohort from 19 spinal cord injury units in 11 countries.
A total of 648 patients with spinal cord injury.
Assessment with Spinal Cord Independence Measure (SCIM IV) and Spinal Cord Independence Measure (SCIM III) on admission to inpatient rehabilitation and before discharge.
SCIM IV interrater reliability, internal consistency, correlation with and difference from SCIM III, and responsiveness.
Total agreement between examiners was above 80% on most SCIM IV tasks. All Kappa coefficients were above 0.70 and statistically significant (P<.001). Pearson's coefficients of the correlation between the examiners were above 0.90, and intraclass correlation coefficients were above 0.90. Cronbach's alpha was above 0.96 for the entire SCIM IV, above 0.66 for the subscales, and usually decreased when an item was eliminated. Reliability values were lower for the subscale of respiration and sphincter management, and on admission than at discharge. SCIM IV and SCIM III mean values were very close, and the coefficients of Pearson correlation between them were 0.91-0.96 (P<.001). The responsiveness of SCIM IV was not significantly different from that of SCIM III in most of the comparisons.
The validity, reliability, and responsiveness of SCIM IV, which was adjusted to assess specific patient conditions or situations that SCIM III does not address, and which includes more accurate definitions of certain scoring criteria, are very good and quite similar to those of SCIM III. SCIM IV can be used for clinical and research trials, including international multi-center studies, and its group scores can be compared with those of SCIM III.
检验脊髓独立测量量表第四版的信度和效度。
与标准的脊髓独立测量量表第三版进行部分盲法比较，并在检查者之间以及检查之间进行比较。
来自11个国家19个脊髓损伤治疗单位的多文化队列。
总共648例脊髓损伤患者。
在患者入院接受住院康复治疗时及出院前，采用脊髓独立测量量表（SCIM IV）和脊髓独立测量量表（SCIM III）进行评估。
SCIM IV的检查者间信度、内部一致性、与SCIM III的相关性及差异，以及反应度。
在大多数SCIM IV任务中，检查者之间的总体一致性超过80%。所有Kappa系数均高于0.70且具有统计学意义（P<0.001）。检查者之间的Pearson相关系数高于0.90，组内相关系数高于0.90。整个SCIM IV的Cronbach's alpha高于0.96，各分量表高于0.66，且剔除一个项目后通常会降低。呼吸和括约肌管理分量表以及入院时的信度值低于出院时。SCIM IV和SCIM III的均值非常接近，它们之间的Pearson相关系数为0.91 - 0.96（P<0.001）。在大多数比较中，SCIM IV的反应度与SCIM III没有显著差异。
SCIM IV针对SCIM III未涉及的特定患者情况或情形进行了调整，包括对某些评分标准的更准确定义，其效度、信度和反应度都非常好，且与SCIM III相当。SCIM IV可用于临床和研究试验，包括国际多中心研究，其组分数值可与SCIM III的进行比较。
