Spinal Cord (2019) 57:874–880 https://doi.org/10.1038/s41393-019-0287-z ARTICLE The Spinal Cord Injury Pressure Ulcer Scale (SCIPUS): an assessment of validity using Rasch analysis Johanne Higgins 1,2,3 ● Marie-Thérèse Laramée 1,2 ● Kate Rousseau Harrison 1,2 ● Jude J. Delparte 4 ● Carol Y. Scovil 4,5 ● Heather M. Flett 4,6 ● Anthony S. Burns 4,7 Received: 24 December 2018 / Revised: 23 April 2019 / Accepted: 24 April 2019 / Published online: 3 May 2019 © International Spinal Cord Society 2019 Abstract Study design Secondary analysis of retrospective data. Objective The aim of this study was to further validate the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) using Rasch analysis. Setting Two rehabilitation centers in Canada. Method Data were collected as part of the Spinal Cord Injury Knowledge Mobilization Network (SCI KMN) initiative. The SCIPUS was completed within 72 h of inpatient admission. Persons admitted for initial rehabilitation in two inpatient spinal cord rehabilitation programs were included in the project. Results Data from 886 participants were analyzed, approximately 60% of whom were males. Rasch analyses demonstrated that the SCIPUS, in its current format did not meet criteria required for true measurement. A transformed version of the SCIPUS obtained by deletion of misfitting items and modification of the response scales improved fit to the model and showed preliminary evidence of unidimensionality. The person separation index, however indicated that the scale requires further adjustments of its scoring options. Conclusions In its original form, the SCIPUS does not meet the requirements of the Rasch model and its total score should be used cautiously. However, following some adjustments to the items such as addressing DIF between sites to insure a standardized assessment across sites and adding response options to some of the items, interval-scale measurement should be possible. Introduction A pressure injury (PI), is defined as a “localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from pressure or a combination of pressure and shear” [1]. PIs are one of the most frequently encountered complications in people with spinal cord injury (SCI) [2]. A quarter of individuals with SCI will develop a PI prior to inpatient rehabilitation [3–7], and prevalence at rehabilitation admission has ranged from 10 to 32% [8, 9]. During inpatient SCI rehabilitation, reported incidence has ranged between 10 and 48% [4, 8–12], and a recent study * Johanne Higgins johanne.higgins@umontreal.ca 1 Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada 2 Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montreal, QC, Canada 3 School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada 4 Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada 5 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada 6 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada 7 Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada Supplementary information The online version of this article (https:// doi.org/10.1038/s41393-019-0287-z) contains supplementary material, which is available to authorized users. 1234567890();,: 1234567890();,: