Development of the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline: Methods and Overview

Overview

Journal J Spinal Cord Med

Date 2021 Nov 15

PMID 34779719

Citations 5

Authors

Eleni M Patsakos

Mark T Bayley

Ailene Kua

Christiana Cheng

Janice Eng

Chester Ho

Vanessa K Noonan

Matthew Queree

B Catharine Craven

Affiliations

Soon will be listed here.

Abstract

Introduction: Spinal cord injury (SCI) is a life-altering injury that leads to a complex constellation of changes in an individual's sensory, motor, and autonomic function which is largely determined by the level and severity of cord impairment. Available SCI-specific clinical practice guidelines (CPG) address specific impairments, health conditions or a segment of the care continuum, however, fail to address all the important clinical questions arising throughout an individual's care journey. To address this gap, an interprofessional panel of experts in SCI convened to develop the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline. This article provides an overview of the methods underpinning the Can-SCIP Guideline process.

Methods: The Can-SCIP Guideline was developed using the Guidelines Adaptation Cycle. A comprehensive search for existing SCI-specific CPGs was conducted. The quality of eligible CPGs was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. An expert panel ( = 52) convened, and groups of relevant experts met to review and recommend adoption or refinement of existing recommendations or develop new recommendations based on evidence from systematic reviews conducted by the Spinal Cord Injury Research Evidence (SCIRE) team. The expert panel voted to approve selected recommendations using an online survey tool.

Results: The Can-SCIP Guideline includes 585 total recommendations from 41 guidelines, 96 recommendations that pertain to the Components of the Ideal SCI Care System section, and 489 recommendations that pertain to the Management of Secondary Health Conditions section. Most recommendations ( = 281, 48%) were adopted from existing guidelines without revision, 215 (36.8%) recommendations were revised for application in a Canadian context, and 89 recommendations (15.2%) were created .

Conclusion: The Can-SCIP Guideline is the first living comprehensive guideline for adults with SCI in Canada across the care continuum.

Citing Articles

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Exploring the Lived Experiences of Individuals With Spinal Cord Injury During the COVID-19 Pandemic.

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Cui Y, Yang B, Lin S, Huang L, Xie F, Feng W Exp Ther Med. 2023; 26(1):340.

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References

Hitzig S, Romero Escobar E, Noreau L, Craven B . Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil. 2011; 93(1):108-14. DOI: 10.1016/j.apmr.2011.07.200. View

Elliott S . Problems of sexual function after spinal cord injury. Prog Brain Res. 2005; 152:387-99. DOI: 10.1016/S0079-6123(05)52026-0. View

Kwon B, Liu J, Messerer C, Kobayashi N, McGraw J, Oschipok L . Survival and regeneration of rubrospinal neurons 1 year after spinal cord injury. Proc Natl Acad Sci U S A. 2002; 99(5):3246-51. PMC: 122504. DOI: 10.1073/pnas.052308899. View

. Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.: Consortium for Spinal Cord Medicine. Top Spinal Cord Inj Rehabil. 2018; 22(3):209-240. PMC: 4981016. DOI: 10.1310/sci2203-209. View

Kong C, Hosseini A, Belanger L, Ronco J, Paquette S, Boyd M . A prospective evaluation of hemodynamic management in acute spinal cord injury patients. Spinal Cord. 2013; 51(6):466-71. DOI: 10.1038/sc.2013.32. View

Rose L, McKim D, Leasa D, Nonoyama M, Tandon A, Kaminska M . Monitoring Cough Effectiveness and Use of Airway Clearance Strategies: A Canadian and UK Survey. Respir Care. 2018; 63(12):1506-1513. DOI: 10.4187/respcare.06321. View

Carr J, Kendall M, Amsters D, Pershouse K, Kuipers P, Buettner P . Community participation for individuals with spinal cord injury living in Queensland, Australia. Spinal Cord. 2016; 55(2):192-197. DOI: 10.1038/sc.2016.169. View

Mulcahey M, Jones L, Rockhold F, Rupp R, Kramer J, Kirshblum S . Adaptive trial designs for spinal cord injury clinical trials directed to the central nervous system. Spinal Cord. 2020; 58(12):1235-1248. DOI: 10.1038/s41393-020-00547-8. View

Johns J, Krogh K, Rodriguez G, Eng J, Haller E, Heinen M . Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury Suggested citation: Jeffery Johns, Klaus Krogh, Gianna M. Rodriguez, Janice Eng, Emily Haller, Malorie Heinen, Rafferty Laredo, Walter Longo, Wilda Montero-Colon, Mark.... J Spinal Cord Med. 2021; 44(3):442-510. PMC: 8115581. DOI: 10.1080/10790268.2021.1883385. View

10.

Fehlings M, Wilson J, Tetreault L, Aarabi B, Anderson P, Arnold P . A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Use of Methylprednisolone Sodium Succinate. Global Spine J. 2017; 7(3 Suppl):203S-211S. PMC: 5686915. DOI: 10.1177/2192568217703085. View

11.

Kornhall D, Jorgensen J, Brommeland T, Hyldmo P, Asbjornsen H, Dolven T . The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury. Scand J Trauma Resusc Emerg Med. 2017; 25(1):2. PMC: 5217292. DOI: 10.1186/s13049-016-0345-x. View

12.

Alavinia S, Hitzig S, Farahani F, Flett H, Bayley M, Craven B . Prioritization of rehabilitation Domains for establishing spinal cord injury high performance indicators using a modification of the Hanlon method: SCI-High Project. J Spinal Cord Med. 2019; 42(sup1):43-50. PMC: 6783798. DOI: 10.1080/10790268.2019.1616949. View

13.

Schurch B, Iacovelli V, Averbeck M, Stefano C, Altaweel W, Agro E . Urodynamics in patients with spinal cord injury: A clinical review and best practice paper by a working group of The International Continence Society Urodynamics Committee. Neurourol Urodyn. 2017; 37(2):581-591. DOI: 10.1002/nau.23369. View

14.

Cadel L, Everall A, Packer T, Hitzig S, Patel T, Lofters A . Exploring the perspectives on medication self-management among persons with spinal cord injury/dysfunction and providers. Res Social Adm Pharm. 2020; 16(12):1775-1784. DOI: 10.1016/j.sapharm.2020.01.014. View

15.

Fehlings M, Tetreault L, Aarabi B, Anderson P, Arnold P, Brodke D . A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Anticoagulant Thromboprophylaxis. Global Spine J. 2017; 7(3 Suppl):212S-220S. PMC: 5684841. DOI: 10.1177/2192568217702107. View

16.

Fehlings M, Martin A, Tetreault L, Aarabi B, Anderson P, Arnold P . A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Role of Baseline Magnetic Resonance Imaging in Clinical Decision Making and Outcome Prediction. Global Spine J. 2017; 7(3 Suppl):221S-230S. PMC: 5684845. DOI: 10.1177/2192568217703089. View

17.

Gainforth H, Hoekstra F, McKay R, McBride C, Sweet S, Martin Ginis K . Integrated Knowledge Translation Guiding Principles for Conducting and Disseminating Spinal Cord Injury Research in Partnership. Arch Phys Med Rehabil. 2020; 102(4):656-663. DOI: 10.1016/j.apmr.2020.09.393. View

18.

Badhiwala J, Ahuja C, Fehlings M . Time is spine: a review of translational advances in spinal cord injury. J Neurosurg Spine. 2019; 30(1):1-18. DOI: 10.3171/2018.9.SPINE18682. View

19.

Fehlings M, Tetreault L, Wilson J, Aarabi B, Anderson P, Arnold P . A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury and Central Cord Syndrome: Recommendations on the Timing (≤24 Hours Versus >24 Hours) of Decompressive Surgery. Global Spine J. 2017; 7(3 Suppl):195S-202S. PMC: 5684850. DOI: 10.1177/2192568217706367. View

20.

Kavanagh A, Baverstock R, Campeau L, Carlson K, Cox A, Hickling D . Canadian Urological Association guideline: Diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction - Full text. Can Urol Assoc J. 2019; 13(6):E157-E176. PMC: 6570608. DOI: 10.5489/cuaj.5912. View