Development and Validation of a Patient-Reported Checklist for Dermatological Complications in Chronic Spinal Cord Injury

Abstract Study Design: Cross-SectionalObjectives:This study aimed to develop and validate a comprehensive, patient-reported checklist for identifying dermatological complications in individuals with chronic SCI Setting Sina Trauma and Surgery Research Center, Sina Hospital, Tehran, IranMethods:A multi-phase, cross-sectional methodological study was conducted. Items were generated via literature review and expert opinion, followed by content validation with a panel of 11 specialists using the Content Validity Ratio (CVR) and Content Validity Index (CVI). After face validation with patient representatives, the final checklist was field-tested in structured interviews with individuals from a national SCI registry. Inter-rater reliability was assessed with Cohen’s Kappa.Results:The final 16-item checklist demonstrated excellent content validity, with all items meeting CVR thresholds and achieving high Scale-Level CVI scores (Relevance = 0.88, Simplicity = 0.92, Clarity = 0.89). Inter-rater reliability was excellent Cohen’s Kappa = 0.89). The tool was administered to 139 individuals with chronic SCI (mean age 43.9 years; 76.8% male), of whom 44.6% (n = 62) reported at least one complication. Of the 102 complications identified, those related to fungal infections (25.5%) and early-stage pressure injuries (20.6%) were the most prevalent. The mean onset time for the first complication was 2.7 months post-injury.Conclusions:The Spinal Cord Injury Skin Complications Checklist (SCI-SCC) is a valid and reliable patient-reported tool for screening dermatological issues in this population. Its integration into routine clinical practice can facilitate standardized monitoring, promote early detection, and ultimately improve patient-centered care for individuals living with chronic SCI.