Study design: Review by the spinal cord outcomes partnership endeavor (SCOPE), which is a broadbased international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives: Assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies. Methods: a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity for human SCI. Results: Imaging, neurological, functional, autonomic, sexual health, bladder/bowel, pain and psychosocial tools were evaluated. Several specific tools for human SCI studies have or are being developed to allow the more accurate determination for a clinically meaningful benefit (improvement in functional outcome or quality of life) being achieved as a result of a therapeutic intervention. Conclusion: Significant progress has been made, but further validation studies are required to identify the most appropriate tools for specific targets in a human SCI study or clinical trial.

As people with disabilities challenge psychology to acknowledge the sociopolitical foundations of their marginalization, they urge psychologists to help improve disability policy within and beyond the borders of the discipline. Understanding disability through a social paradigm offers opportunities to reframe the way psychologists define problems related to disability, to develop more collaborative relationships between psychologists and people with disabilities, and to adopt new professional responsibilities with respect to the disability community. The authors address the impact of the social paradigm on policies within psychology that guide consulting, advocacy, and training. The impact of national policy decisions, such as those associated with reimbursement, on practice and training is also discussed. Highlighted throughout are points of controversy prompted by new disability frameworks that remain open to illumination from the field.

Linking records to create the study data base was arduous and could not be practically accomplished on a large scale or on a continuing basis. Because of the growing emphases on trauma system evaluations and outcomes beyond survival at acute care discharge, we recommend the routine inclusion of rehabilitation data in hospital-based trauma registries.

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