Computerized Classification of Neurologic Injury Based on the International Standards for Classification of Spinal Cord Injury

Background/Objective: To develop and test a computer program to accurately score International Standards for Classification of Spinal Cord Injury (ISCSCI) examinations. Methods: A computer program was written following the algorithm published in the ISCSCI 2003 manual. Two methods were used to test the computer program's accuracy. First, 94 hand-scored examinations representing 25 different patients were entered into the program. Differences between hand-scored examinations and computer-scored examinations were evaluated for accuracy. Second, all case examples from the ISCSCI manual were entered into the computer program to verify its accuracy. Results: Of the 94 hand-scored examinations, the computer detected all incorrectly scored examinations. Furthermore, the computer scoring agreed with every examination's scores that were correctly calculated by hand. Of the hand-scored examinations, 10% of sensory total scores and 4% of motor scores were incorrect. For sensory level and motor level, there were errors in 9% and 26% of hand-scored examinations, respectively; 13% of hand-scored examinations had incorrectly assigned ASIA Impairment Scale classification. Conclusion: This study showed that the computer program we developed was effective in correctly scoring ISCSCI examinations and was able to detect errors in hand-scored examinations.