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J Neurotrauma. 2018 Feb 1;35(3):478-485. doi: 10.1089/neu.2017.5036. Epub 2017 Oct 27.

Facilitators and Barriers to International Collaboration in Spinal Cord Injury: Results from a Survey of Clinicians and Researchers.

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1 Rick Hansen Institute , Vancouver, British Columbia, Canada .
2 Ontario Neurotrauma Foundation , Toronto, Ontario, Canada .
3 Institute for Breathing and Sleep , Austin Health, Melbourne, Victoria, Australia .
4 Spinal Research Institute , Melbourne, Victoria, Australia .
5 Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen , Copenhagen, Denmark .
6 Craig Hospital , Englewood, Colorado.
7 The European Spinal Cord Injury Federation , Nottwil, Switzerland .
8 Institute for Safety , Compensation and Recovery Research, Melbourne, Victoria, Australia .
9 WorkSafe Victoria , Melbourne, Australia .
10 Victoria University of Wellington , Wellington, New Zealand .


International collaboration in spinal cord injury (SCI) research is necessary to overcome the challenges often encountered by clinicians and researchers, including participant recruitment, high cost, and the need for specialized expertise. However, international collaboration poses its own obstacles. The objective of this study was to conduct an international online survey to assess barriers and facilitators to international SCI clinical research, potential initiatives to facilitate future collaborations, and the use of SCI-specific data sets and standards. Results were analyzed using descriptive statistics. Of 364 total respondents, 213 completed the survey, with the majority of these participants based in North America (38%), Asia (22%), Europe (18%), and Oceania (16%). Over half had more than 10 years of experience in SCI research or clinical practice (57%) and 60% had previous experience with international collaborations. Funding was identified as a top barrier (82%), a facilitator (93%), and a proposed future initiative (97%). Communication and technology were also identified as strong facilitators and proposed future initiatives. The International Standards for Neurological Classification of SCI were used by 69% of participants, the International Standards to document remaining Autonomic Function after SCI by 13% of participants, and the International SCI Data Sets by 45% of participants. As the need for international collaborations in SCI research increases, it is important to identify how clinicians and researchers can be supported by SCI consumer and professional organizations, funders, and networks. Furthermore, unique solutions to overcome modifiable barriers and creation of new facilitators are also needed.


clinical research; international collaboration; spinal cord injury; standardization

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