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| traumatic_spinal_cord_injury_prognosis [2025/07/17 17:41] – [Critical Review] administrador | traumatic_spinal_cord_injury_prognosis [2025/07/17 17:41] (current) – [Critical Review] administrador |
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| **Limitations** | **Limitations** |
| 1. **Retrospective design:** Limits causal interpretation; heterogeneity in rehabilitation protocols and data collection over two decades and across centers may confound findings. | 1. **Retrospective design:** Causal inference is limited; variability in rehabilitation protocols and data fidelity across centers and time likely introduced bias. |
| 2. **Short follow-up window:** Outcomes restricted to 1 year post-injury; no assessment of sustained or delayed recovery. | 2. **Temporal scope:** One-year follow-up offers no insight into long-term functional trajectories or sustained recovery patterns. |
| 3. **Sex imbalance:** Female patients constituted only 20% of the cohort, undermining the robustness of sex-specific analyses and reducing external validity. | 3. **Sex disparity:** With females comprising only 20% of the cohort, sex-specific analyses are underpowered and generalizability is constrained. |
| 4. **Unmeasured confounders:** Key determinants—such as socioeconomic status, caregiver availability, and rehabilitation quality—were not accounted for, likely biasing results. | 4. **Unmeasured variables:** Socioeconomic status, caregiver support, and rehabilitation quality were not captured, leaving residual confounding unaddressed. |
| 5. **Uncertain clinical relevance:** The reported 3.1-point FIM difference, though statistically significant, lacks contextualization via MCID, casting doubt on its practical significance. | 5. **Marginal clinical significance:** The 3.1-point FIM difference, while statistically significant, lacks anchoring to a defined MCID, weakening its real-world applicability. |
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