Chronic SCI Patients Favor Administration of Methylprednisolone for Acute SCI.

<p>Patient responses to survey questions related to MPSS use for acute SCI are shown. Chi-square testing revealed that responses to all questions differed significantly from expected responses in which all possible answers would have been selected with equal frequency. The sample size for (<b>A</b>), (<b>B</b>), (<b>C</b>), (<b>D</b>) and (<b>E</b>) were 69, 68, 74, 69 and 44 respectively. MPSS = methylprednisolone sodium succinate, SCI = spinal cord injury.</p

A Hype Cycle of Methylprednisolone for Acute Spinal Cord Injury.

<p>The Gartner Hype Cycle describes a common pattern in the adoption of new technologies. Here we propose a Steroid Hype Cycle for Spinal Cord Injury. We contend that the press release of the NASCIS II data in advance of scientific review conforms to a “Peak of Inflated Expectations” while the 2013 Acute Spinal Cord Injury Guidelines are akin to a “Trough of Disillusionment”. This cycle predicts selective administration of methylprednisolone in the future. MPSS = methylprednisolone sodium succinate.</p

Experts Adjudicated the Datasheet Provided to Spinal Cord Injured Patients as Being Neutral, With Minimal Bias and of High Quality.

<p>The authors constructed a datasheet summarizing the literature informing the use of MPSS for SCI. To verify its acceptability prior to distributing to SCI patients we asked twenty eight experts in spinal cord injury to adjudicate the document. The three questions asked of the adjudicators and the frequency of responses is demonstrated above. 27 respondents answered each of the 3 questions. When asked to evaluate whether the information sheet favored (5) or discouraged steroid use (1), the median score was 3 and the mode was 3 (3 = neutral on 5-point Likert scale). Similarly, the median score indicating whether the sheet demonstrated bias was 1 and the mode was 1 (1 = no bias and 5 = extreme bias on a 5-point Likert scale), and the median score for quality of the created survey was 5 and mode was 5 (1 = poor and 5 = excellent on 5-point Likert scale). MPSS = methylprednisolone sodium succinate; SCI = spinal cord injury.</p

Patients Report Little Input into Decision to Administer Methylprednisolone.

<p>Responses of spinal cord injured patients to survey questions related to MPSS discussion and administration. Data reflects the responses of patients who reported presenting to the hospital within 8h of injury conscious and able to talk to the physicians. In panels (<b>A</b>), (<b>B</b>), and (<b>C</b>) the number of respondents choosing each response is plotted. The sample size for (<b>A</b>), (<b>B</b>), (<b>C</b>), were 24, 24, and 23. MPSS = methylprednisolone sodium succinate.</p