Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments

Schuld, Christian; Wiese, Julia; Hug, Andreas; Putz, Cornelia; van Hedel, Hubertus J. A.; Spiess, Martina R.; Weidner, Norbert; Rupp, Rüdiger

doi:10.1089/neu.2011.2085

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments
Authors:	Schuld, Christian Wiese, Julia Hug, Andreas Putz, Cornelia van Hedel, Hubertus J. A. Spiess, Martina R. Weidner, Norbert Rupp, Rüdiger
et. al:	No
DOI:	10.1089/neu.2011.2085
Published in:	Journal of Neurotrauma
Volume(Issue):	29
Issue:	3
Page(s):	453
Pages to:	461
Issue Date:	Feb-2012
Publisher / Ed. Institution:	Mary Ann Liebert
ISSN:	0897-7151 1557-9042
Language:	English
Subjects:	Algorithm; Computer; Data interpretation, Statistical; Disability evaluation; Humans; Movement; Nervous system disease; Neurologic examination; Recovery of function; Reproducibility of result; Sensation; Software; Spinal cord Injury
Subject (DDC):	005: Computer programming, programs and data 616.8: Neurology, diseases of nervous system
Abstract:	The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), defined by the American Spinal Injury Association (ASIA), and particularly the ASIA Impairment Scale (AIS) are widely used for research and clinical purposes. Although detailed procedures for scaling, scoring, and classification have been defined, misclassifications remain a major problem, especially for cases with missing (i.e., not testable [NT]) data. This work aimed to implement computer-based classification algorithms that included rules for handling NT data. A consistent and structured algorithmic scoring, scaling, and classification scheme, and a computerized application have been developed by redefining logical/mathematical imprecisions. Existing scoring rules are extended for handling NT segments. Design criterion is a pure logical approach so that substitution of non-testability for all valid examination scores leads to concordant results. Nine percent of 5542 datasets from 1594 patients in the database of the European Multicenter Study of Human Spinal Cord Injury (EM-SCI) contained NT segments. After adjusting computational algorithms, the classification accuracy was equivalent between clinical experts and the computational approach and resulted in 84% valid AIS classifications within datasets containing NT. Additionally, the computational method is much more efficient, processing approximately 200,000 classifications/sec. Computational algorithms offer the ability to classify ISNCSCI subscores efficiently and without the risk of human-induced errors. This is of particular clinical relevance, since these scores are used for early predictions of neurological recovery and functional outcome for patients with spinal cord injuries.
URI:	https://digitalcollection.zhaw.ch/handle/11475/25604
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Occupational Therapy (IER)
Appears in collections:	Publikationen Gesundheit

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Schuld, C., Wiese, J., Hug, A., Putz, C., van Hedel, H. J. A., Spiess, M. R., Weidner, N., & Rupp, R. (2012). Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments. Journal of Neurotrauma, 29(3), 453–461. https://doi.org/10.1089/neu.2011.2085

Schuld, C. et al. (2012) ‘Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments’, Journal of Neurotrauma, 29(3), pp. 453–461. Available at: https://doi.org/10.1089/neu.2011.2085.

C. Schuld et al., “Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments,” Journal of Neurotrauma, vol. 29, no. 3, pp. 453–461, Feb. 2012, doi: 10.1089/neu.2011.2085.

SCHULD, Christian, Julia WIESE, Andreas HUG, Cornelia PUTZ, Hubertus J. A. VAN HEDEL, Martina R. SPIESS, Norbert WEIDNER und Rüdiger RUPP, 2012. Computer implementation of the international standards for neurological classification of spinal cord injury for consistent and efficient derivation of its subscores including handling of data from not testable segments. Journal of Neurotrauma. Februar 2012. Bd. 29, Nr. 3, S. 453–461. DOI 10.1089/neu.2011.2085

Schuld, Christian, Julia Wiese, Andreas Hug, Cornelia Putz, Hubertus J. A. van Hedel, Martina R. Spiess, Norbert Weidner, and Rüdiger Rupp. 2012. “Computer Implementation of the International Standards for Neurological Classification of Spinal Cord Injury for Consistent and Efficient Derivation of Its Subscores Including Handling of Data from Not Testable Segments.” Journal of Neurotrauma 29 (3): 453–61. https://doi.org/10.1089/neu.2011.2085.

Schuld, Christian, et al. “Computer Implementation of the International Standards for Neurological Classification of Spinal Cord Injury for Consistent and Efficient Derivation of Its Subscores Including Handling of Data from Not Testable Segments.” Journal of Neurotrauma, vol. 29, no. 3, Feb. 2012, pp. 453–61, https://doi.org/10.1089/neu.2011.2085.