Physical Health Conditions in Persons with Spinal Cord Injury Across 21 Countries Worldwide.

The study relied entirely on self-reported data without medical verification, which may introduce reporting bias. Most countries (14 of 21) used convenience sampling rather than random sampling, limiting the generalizability of country-specific results. The cross-sectional design means associations cannot be interpreted as causal. Response rates varied significantly across countries (23% to 54%), and characteristics of non-responders were largely unknown, raising concerns about non-response bias. Switzerland was excluded from the analysis due to different survey response options, reducing the total sample size.

The study was conducted by the International SCI Community Survey (InSCI). The text notes that data use is restricted to participating countries and provides a contact email for collaboration. No specific commercial funding sources or conflicts of interest for individual authors are detailed in the provided text.

Do not assume that the high prevalence rates in high-income countries reflect a worse health status compared to low-income countries. The authors note that these differences may reflect socioeconomic and cultural differences in reporting thresholds, meaning the real disease burden in some countries is likely underestimated.