Archive for the 'Spinal cord injury' Category

Using ASIA Motor Score as outcome in spinal injury

7 January 2008

In October ‘06, the people at ICORD (International Collaboration On Repair Discoveries) in Vancouver asked me to give a talk. I spoke on Statistical Considerations in Designing a Trial in Spinal Cord Injury with ASIA Motor Score as the Outcome, and you can download a 1.5 MB pdf copy of my slides. I tend to write everything I plan to say into my slides, so they’re less schematic and easier to read than most.

Recently there have been many potential treatments for spinal cord injury reaching the stage of development where they’re ready for human trials, and thus there’s interest in using previous data to develop design information. The largest existing data set is the one from the Sygen GM-1 multi-center trial, which recruited 760 patients in 28 centers in the US and Canada in the 1990s. I was a designer of it, and so my colleagues and I have been trying to be helpful in filling requests for information.

This talk summarizes my preliminary thoughts about using the ASIA (American Spinal Injury Association) motor score as the outcome variable. Read the rest of this entry »

Reduced Bladder and Bowel Control after Severe Spinal Cord Injury — Even in Patients Able to Walk

29 December 2007

Regaining unlimited mobility, including the ability to walk, is a main goal for spinal-cord-injured (SCI) patients. Still, more limited accomplishments — such as bladder and bowel control — would significantly improve quality of life for those lacking them. Conferences and publications have cited such endpoints as under-studied.

In the 1990s, Fred Geisler and I were the designers of the Sygen multi-center trial in acute SCI. Later, we collaborated with Kim Anderson, using the data from that trial to investigate the relation between the ability to walk and bowel and bladder control.

We found that bowel and bladder impairment, representing a serious impact on quality of life, affect a very large portion of the SCI population and are a significant problem, separate from ambulation and needing specifically directed work.

You can download a pdf slide presentation showing the details of our results.