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A Trial in Spinal Cord Injury with ASIA Motor Score as the Outcome, and you can download a 1.5 MB pdf copy. ASIA Motor Score as outcome in spinal. ASIA Impairment Scale (AIS) Steps in Classification. The following order is recommended for determining the classification of. Individuals with SCI.

In October ’06, the people at (International Collaboration On Repair Discoveries) in Vancouver asked me to give a talk. I spoke on, 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.

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. This score is highly useful and well-known and -validated as a clinical tool — for individual patients — but its properties in a research setting — for aggregate groups of patients — are poorly understood. We are in a long-term program to study it using our data.

Here’s a summary of what these slides deal with. It’s important to avoid ceiling effects: patients with complete injuries tend to recover very little, so that it’s hard for any treatment to make headway — while patients with milder injuries almost always recover significantly, so that it’s hard for any treatment to appear better than placebo, especially at later measurements.

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It was hoped that the ASIA motor score would be a more sensitive measure than the ASIA Impairment Scale (AIS) and be less prone to this — but it still has difficulties. The sample size estimates are based on the Sygen data. Recruitment was very uneven: much higher for cervical injuries than for thoracic, and much higher for complete injuries than incomplete. Further, due to the nature of the measurement process, the ASIA motor score is prone to artifacts in a research setting that would not be noticed clinically. In particular, its distribution is very asymmetrical and different in different population subgroups. Therefore the standard deviation observed in any trial (and, accordingly, the sample size needed) can vary drastically depending on the proportion in which these subroups are recruited.

Kim Anderson’s survey of spinal injury patients has shown the desirability of alternative outcome measures — better use of arms and hands, upper body/trunk strength and balance, bowel and bladder control, blood pressure regulation, sexual function, normal sensation, and pain relief. These outcomes do not necessarily accompany, nor are they necessarily accompanied by, the return of ability to walk. (See, for example, an earlier blog engtry:.) It is important to model covariates, and the Sygen data show the most important ones are AIS grade at baseline, cervical vs thoracic, timing of decompressive surgery, mild injury (central cord, no fracture dislocation, or not requiring decompressive surgery), and age. Philosophy, classics, art, movies, literature, writing fiction and screenplays, my photography — also logic, artificial intelligence, mathematics, biostatistics, medical research. In other words, both halves of my brain: thinking in pictures and thinking in words.

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(2). Search this blog. If you'd like to know more about me, please see the page. My qualifications for the scientific entries are in.

I see no reason to segregate scientific and technical posts from humanistic ones. In my life, scientific concerns mix with ethical ones, and they shade into a philosophical interest in the nature of cognition and the nature of people. Doing science is as creative as writing fiction, and I get inspiration for both from the same gods. You will find little here on current politics.

I'm an activist, but not in symptoms. Experience in martial arts shows me that the sure way to lose is reactivity; but if you stay cool and remember your training and what you're there for then you achieve goals and, when conflict is unavoidable, you fight and win.

The idea of the liberal arts I was brought up in is that broad understanding of cultures and ideas gives you deeper, better goals - making success more likely and more satisfying. Negatively, the hysteria since 9/11 shows how a country frightened and reactive can destroy itself more than an enemy can. I'm trying to contribute by changing the terms of discourse. As, 'America, I'm putting my queer shoulder to the wheel.' One fact shouldn't require special mention, but it sometimes does: namely that I'm gay.

This blog is not primarily about being gay, but the topic sometimes comes up. I'm proud of being gay and do not hide.