Healthcare Provider Perspectives of Various Signs and Symptoms for Diagnosing Degenerative Cervical Myelopathy: Results of an International, Multidisciplinary Survey
Journal
Muscle & Nerve
ISSN
0148-639X
Date Issued
2025-12-03
Author(s)
Lance A. Burn
Tanzil Rujeedawa
Abdul Lalkhen
Allan R. Martin
Anna MacDowall
Brian K. Kwon
Carl M. Zipser
Caroline Treanor
David B. Anderson
Esther Martin‐Moore
James Guest
James S. Harrop
Jamie Milligan
Julio C. Furlan
Konstantinos Margetis
Lianne Wood
Ligia V. Onofrei
Luiz R. Vialle
Manabu Ito
Mark Kotter
Michael G. Fehlings
Michael W. Y. Lee
Mike Hutton
Noam Y. Harel
Rohil V. Chauhan
Sheila Dugan
Sukhvinder Kalsi‐Ryan
Sybil Stacpoole
Tammy Blizzard
Timothy F. Boerger
Tore K. Solberg
Justin M. Lantz
Benjamin Davies
Lindsay Tetreault
Type
journal-article
Abstract
<jats:title>ABSTRACT</jats:title>
<jats:sec>
<jats:title>Introduction/Aims</jats:title>
<jats:p>
Diagnosis of degenerative cervical myelopathy (
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
) is frequently delayed. A lack of awareness and standardized screening criteria have been identified as major contributors. The objective of this study was to conduct a survey of international experts to determine the value of various signs and symptoms in diagnosing patients with
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. This study forms part of a three‐step initiative that aims to develop pragmatic screening criteria for
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>
An open voluntary English‐language Likert scale survey was disseminated among international networks of experts in
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. Respondents were asked to rank each sign or symptom on a scale of 0 (
<jats:italic>not important at all</jats:italic>
) to 10 (
<jats:italic>extremely important</jats:italic>
); a mean value of ≥ 6.5 was set a priori as the threshold to consider a feature as having significant diagnostic value.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Fifteen symptoms and 12 signs were ranked as having significant diagnostic value. The most highly ranked symptoms are primarily related to abnormalities of the upper limb, hand function, and gait. The top‐rated signs included pathological reflexes as well as impairment of motor function, gait, and coordination. Features ranked as significant were largely consistent across professions, levels of experience, and continental regions.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Discussion</jats:title>
<jats:p>
The integration of expert stakeholder opinion with evidence from existing literature strengthens the clinical framework for identifying key clinical features of
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. These 27 features will be discussed at an international consensus meeting to establish a standardized clinical screening toolkit that can be used by frontline healthcare professionals to detect patients with
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Introduction/Aims</jats:title>
<jats:p>
Diagnosis of degenerative cervical myelopathy (
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
) is frequently delayed. A lack of awareness and standardized screening criteria have been identified as major contributors. The objective of this study was to conduct a survey of international experts to determine the value of various signs and symptoms in diagnosing patients with
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. This study forms part of a three‐step initiative that aims to develop pragmatic screening criteria for
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>
An open voluntary English‐language Likert scale survey was disseminated among international networks of experts in
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. Respondents were asked to rank each sign or symptom on a scale of 0 (
<jats:italic>not important at all</jats:italic>
) to 10 (
<jats:italic>extremely important</jats:italic>
); a mean value of ≥ 6.5 was set a priori as the threshold to consider a feature as having significant diagnostic value.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Fifteen symptoms and 12 signs were ranked as having significant diagnostic value. The most highly ranked symptoms are primarily related to abnormalities of the upper limb, hand function, and gait. The top‐rated signs included pathological reflexes as well as impairment of motor function, gait, and coordination. Features ranked as significant were largely consistent across professions, levels of experience, and continental regions.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Discussion</jats:title>
<jats:p>
The integration of expert stakeholder opinion with evidence from existing literature strengthens the clinical framework for identifying key clinical features of
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
. These 27 features will be discussed at an international consensus meeting to establish a standardized clinical screening toolkit that can be used by frontline healthcare professionals to detect patients with
<jats:styled-content style="fixed-case">DCM</jats:styled-content>
.
</jats:p>
</jats:sec>