Table 2. Overall comparison of PRISM and SCI-SET from a clinical practice perspective.
| Parameter | PRISM34 | SCI-SET35 |
|---|---|---|
| Scientific quality based on COSMIN evaluation | Good or fair | Generally fair, some aspects poor; but probably adequate scientific quality |
| ICF coverage (number of items) |
Body function: focus primarily mental (mental function 13; genitourinary & reproductive 1) Activity & participation: wider coverage of self-care and interpersonal domains (general tasks 2; mobility 8; self-care 10; interpersonal & relationships 11; community, social & civic 1) |
Body function: wider coverage (mental function 9 items; sensory & pain 1 item; genitourinary & reproductive 1 item; neuromusculoskeletal & movement 3 items) Activity & participation: wider mobility coverage (general tasks 2; mobility 12; self-care 5; domestic life 2; interpersonal 2; community 1) |
| Clinical relevance in SCD | Adequate but may be less relevant than SCI-SET in the context of SCD Similar to a conventional HRQoL measure; less coverage of symptoms; does not assess sleep; less sensitive to positive aspects of spasticity |
More intuitive and clinically useful than PRISM Better coverage of symptoms; assesses sleep; better sensitivity to positive aspects |
| Clarity of questions and ease of interpretation | Questions more specific; answers clearer to interpret; has subscales | Some ambiguity, e.g. difference between “not applicable” and “no effect” could confuse; no subscales |
| Generalizability to all spasticity versus specificity for SCD | More generalizable to spasticity across conditions | Developed specifically for SCD |
| Sensitivity, responsiveness and validity | Respondents experiencing no spasticity could answer “never or rarely” Validity of PRISM subscales has been reported using a clinically assessed sample of patients. PRISM subscale scores corresponded to statistically significant mean rank scores, indicating the more severe the spasticity, the greater the PRISM score (greater the impact of spasticity)34 Minimal clinically important difference (MCID) has not been assessed for PRISM to date |
Not apparent how answers would change if a person no longer had spasticity. Some intervention studies have found no change in SCI-SET score despite changes in clinical measures of spasticity.35,61 This is not surprising as the SCI-SET is unbiased towards positive and negative effects of spasticity SCI-SET has shown moderate to strong correlations with self-assessed spasticity severity and spasticity impact35 |
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