Pulse article: Survey on the current usage of the International Standards for the Assessment of Autonomic Function after Spinal Cord Injury (ISAFSCI)

Spinal Cord Series and Cases, 2017 · DOI: 10.1038/s41394-017-0025-8 · Published: October 3, 2017

Simple Explanation

The study aimed to understand how the International Standards for the Assessment of Autonomic Function after Spinal Cord Injury (ISAFSCI) are being used by clinicians. A survey was conducted to gather opinions on the usefulness of the ISAFSCI and to identify areas for improvement. The results showed that while some clinicians find the ISAFSCI useful, many are not aware of its benefits or how to use it effectively.

Study Duration

2 months

Participants

173 clinical providers

Evidence Level

Not specified

Key Findings

1
Only a small percentage of respondents use the ISAFSCI regularly in their clinical practice.
2
A significant number of clinicians are unsure of the difference between the ISAFSCI and the International Data Sets.
3
The bladder, bowel, and sexual function sections of the ISAFSCI, as well as the heart rate, respiratory rate, blood pressure, and sudomotor sections for use in patients with tetraplegia, were reported as most useful.

Research Summary

This survey has addressed the current use, perceived usefulness, and recommendations for modiﬁcation to the current edition of the ISAFSCI. The survey results revealed the need to further educate clinical healthcare providers, not only about the purpose of the ISAFSCI, but also regarding the importance of assessing and communicating in more detail the impact of SCI on autonomic nervous system control of organ system function. The results of this survey suggest the need for the ISAFSCI to provide information regarding the probable impact of injury level on speciﬁc autonomic responses, rather than just querying the patient regarding these functions.

Practical Implications

Improved Education

There is a clear need for better education and training on the ISAFSCI for clinicians.

ISAFSCI Revision

The ISAFSCI should be revised to include more detailed explanations and address areas of ambiguity.

Integration with ISNCSCI

Consideration should be given to integrating the ISAFSCI with the ISNCSCI to improve adoption and usage.

Study Limitations

1
Internet-based survey subject to response bias
2
Relatively low number of respondents
3
Possible that only physicians who were interested and aware of the topic responded

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