Abstract
Study design:
This is a survey-based study.
Objective:
To investigate the practice of spinal cord injury (SCI) core data collection by Chinese physicians to measure the extent and accuracy of routine collection of elements contained in the International Spinal Cord Injury Core Data Set (ISCICDS).
Setting:
This study was conducted in a workshop in Peking University, China.
Methods:
During an SCI workshop, a survey questionnaire was administered to 48 physicians from 20 provinces of China. The questions were developed on the basis of the data elements within the ISCICDS including the following issues: date of birth, injury, acute admission and inpatient discharge, total hospitalized days, gender, injury etiology, vertebral injury, associated injury, spinal surgery, ventilatory assistance and place of discharge. In addition, data collection practice on neurologic examinations including date, neurological level, injury severity and frequency of examination were involved.
Results:
The self-reported practice of data collection regarding date of birth, acute admission and inpatient discharge, gender, vertebral injury, associated injury, spinal surgery and frequency of neurological examination are consistent with the information in the ISCICDS among the majority (⩾76%) of physicians. However, only gender, vertebral injury, associated injury and spinal surgery are completely consistent. The consistency percentages of other data elements ranged from 39.5 to 66.8%.
Conclusion:
Apart from four data elements, which were collected consistently with the intention in the ISCICDS, the collection of other core data elements need to be documented according to the guidelines included in the ISCICDS to ensure consistency of practice among Chinese physicians and to support worldwide comparison of SCI data.
Suggestion:
Only four data elements are collected in complete accordance with the ISCICDS by Chinese physicians. ISCICDS guidelines for the remaining elements need to be more rigorously adhered to in order to promote consistency and comparability of data.
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Appendix
Appendix
Spinal Cord Injury Core Data Documentation Questionnaire
(The response with underline in each question is in correspondence with the information in the International Spinal Cord Injury Core Data Set)
1. In the chart, does it contain birth date information of individuals with SCI?
A. Yes, document as YYYY
B. Yes, document as YYYYMM
C. Yes, document as YYYYMMDD
D. No, never document
2. In the chart, how do you document injury date of individuals with SCI?
A. YYYY
B. YYYYMM
C. YYYYMMDD
D. Never document
3. In the chart, does it contain acute admission date information of individuals with SCI?
A. Yes, document as YYYY
B. Yes, document as YYYYMM
C. Yes, document as YYYYMMDD
D. No, never document
4. In the chart, does it contain final inpatient discharge date information of individuals with SCI?
A. Yes, document as YYYY
B. Yes, document as YYYYMM
C. Yes, document as YYYYMMDD
D. No, never document
5. From the information in the chart, how do you calculate total days hospitalized of individuals with SCI?
A. From acute admission to final discharge excluding days temporarily discharged pending readmission (that is, acute phase in orthopedic department and various rehabilitation phases altogether)
B. Calculate acute phase in orthopedic department and subsequent rehabilitation phase in the same hospital
C. Only calculate rehabilitation phase
D. Never calculate
6. In the chart, does it contain gender information of individuals with SCI?
A. Yes, document as male and female
B. No, never document
7. In the chart, how do you document injury etiology of individuals with SCI?
A. Only classify as traumatic or non-traumatic
B. Classify as traumatic or non-traumatic, traumatic injury subdivision as following order: sport/leisure, violence, transport, fall and other Traumatic according to ICECI
C. Classify as traumatic or non-traumatic, traumatic injury subdivision but not as same as the subtypes in response B
D. Never documented
8. In the chart, how do you document vertebral injury of individuals with SCI?
A. Only document as present or not
B. Document detail as response A, and also document injured vertebral level
C. Document detail as response B, and also document injured vertebral structure
D. Never document
9-1. In the chart, how do you document associated injury of individuals with SCI?
A. Only document accompanied traumatic brain injury
B. Document major associated injuries as 9-2 listed
C. Document any associated injuries
D. Never document
10. In the chart, how do you document spinal surgery of individuals with SCI?
A. Only document as present or not
B. Document detail as response A, and also document surgical approaches
C. Document detail as response B, and also document detailed surgical methods
D. Never document
11. In the chart, how do you document ventilatory assistance of individuals with SCI?
A. Only document as present or not
B. Document utilization time per day of ventilatory assistance
C. Document utilization time per day and type of ventilatory assistance
D. Never document
12-1. In the chart, do you document place of discharge of individuals with SCI?
A. Yes, document any places
B. Yes, document and describe the detailed address
C. No, never document
12-3. In the chart, do you document any other place of discharge different from those in 12-2 above in individuals with SCI?
A. Document the place of discharge if present
B. Document and describe the detailed address
C. Never document
13. In the chart, do you document dates of the neurologic examinations for individuals with SCI?
A. Yes, document as YYYYMMDD
B. Yes, document as YYYYMM
C. Yes, document as YYYY
D. Days post injury
E. Days post-surgery
F. Never document
14. In the chart, how do you document injury level of individuals with SCI?
A. Only document single neurological level of injury
B. Document motor level and sensory level separately
C. Document motor level and sensory level in right and left side separately
D. Never document
15. In the chart, do you document injury severity of individuals with SCI?
A. ASIA Impairment Scale
B. Complete and incomplete injury
C. Motor complete and motor incomplete injury
D. Never document
16. In the chart, how often do you document injury level and AIS of individuals with SCI?
A. Only document at admission
B. Only document at discharge
C. Document at admission and at discharge separately
D. Document at admission, every one week after injury and at discharge
E. Never document
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Liu, N., Hu, ZW., Zhou, MW. et al. The practice of spinal cord injury core data collection among Chinese physicians: a survey-based study. Spinal Cord 53, 658–662 (2015). https://doi.org/10.1038/sc.2014.217
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DOI: https://doi.org/10.1038/sc.2014.217
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