Reliability validity and responsiveness of the spinal cord independence measure 4th version in a multicultural setup

Abstract Objective To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity. Design Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations. Setting A multicultural cohort from 19 spinal cord injury units in 11 countries. Participants Six hundred and forty-eight patients with spinal cord injury. Intervention Assessment with Spinal Cord Independence Measure (SCIM IV) and Spinal Cord Independence Measure (SCIM III) on admission to inpatient rehabilitation and before discharge. Main outcome measures SCIM IV interrater reliability, internal consistency, correlation with and difference from SCIM III, and responsiveness. Results Total agreement between examiners was above 80% on most SCIM IV tasks. All Kappa coefficients were above 0.70 and statistically significant (p Conclusions The validity, reliability, and responsiveness of SCIM IV, which was adjusted to assess specific patient conditions or situations that SCIM III does not address, and which includes more accurate definitions of certain scoring criteria, are very good and quite similar to those of SCIM III. SCIM IV can be used for clinical and research trials, including international multi-center studies, and its group scores can be compared with those of SCIM III.