• Open Access

Prospectively Recorded versus Medical Record-Derived Spinal Cord Injury Scores in Dogs with Intervertebral Disk Herniation

Authors


  • The majority of the study was conducted at Texas A&M University where dogs were initially admitted, medical records were abstracted, and data were collected. Neurologic scores were reconstructed by board certified neurologists at Texas A&M University, Iowa State University and Washington State University from digitized abstracted medical records generated at Texas A&M University. Statistical analysis and portions of the study design were performed at the University of Pretoria. The study was not supported by extramural or intramural grant funding. This study has not been presented at a national or local meeting

Corresponding author: Dr J.M. Levine, Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843; e-mail: jlevine@cvm.tamu.edu

Abstract

Background

Validated spinal cord injury (SCI) scores have been established for veterinary species but are not uniformly used in practice.

Hypothesis/objectives

To determine the level of agreement of SCI scores at the time of admission versus those assigned from reconstructed medical records in a population of dogs with intervertebral disk herniation (IVDH).

Animals

Eighty-six client-owned dogs with confirmed IVDH.

Methods

Retrospective study. Medical records were reviewed for history, physical examination, neurologic examination, and recorded Modified Frankel score (MFS) and Texas spinal cord injury score (TSCIS) at the time of admission. Three raters, all board-certified neurologists, assigned MFS and TSCIS based on digitized abstracted medical records to each patient. These scores were then compared to the recorded score at the time of admission.

Results

Actual agreement for MFS and TSCIS derived from medical records by the 3 raters compared to prospectively derived MFS and TSCIS was 77.9 and 51.2%, respectively. A kappa value of 0.572 (95% CI 0.450, 0.694; P < .001) and an ICC of 0.533 (95% CI 0.410, 0.646; P < .001) were calculated for MFS scores. A kappa value of 0.100 (95% CI 0.000, 0.222; P = .107), and an ICC of 0.503 (95% CI 0.377, 0.620; P < .001) were calculated for TSCIS scores.

Conclusions and Clinical Importance

Results showed that SCI scores recorded at the time of admission often do not agree with those retrospectively abstracted from medical records. Agreement was less when using the more complex TSCIS scale and therefore the MFS scale might be more appropriate for use in retrospective studies.

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