I read with great interest the recent study by Escorpizo et al. published in Spinal Cord [1], which investigates the connection between employment status, quality of life (QoL), and self-perceived health (SPH) in individuals with spinal cord injury (SCI). While the study provides valuable insights, there are specific aspects that could benefit from further attention and exploration by the authors.

Firstly, the presentation of the main results poses challenges for readers in terms of interpretation. Path analysis was conducted separately for each quartile, categorized based on a country’s gross domestic product (GDP). Within each path, variables such as the independent variable, dependent variables, and covariates were examined. The independent variable examined was “employment status”, while the dependent variables encompassed QoL and SPH. Covariates included multiple factors such as age, gender, education, married/partner status, years since SCI, tetraplegia, complete SCI, and years unemployed after SCI. The findings indicated a positive association between employment and favorable ratings for both QoL and SPH. Conversely, being employed reduced the likelihood of reporting poor outcomes, as reflected by negative coefficients. However, it is important to note that these associations did not achieve statistical significance across all models. Additionally, covariates with direct effects on QoL and SPH were randomly distributed across the GDP quartiles. The complexity of multiple variables and paths contributed to the difficulty in interpreting the results. Upon examination of Figure 1 itself [1], readers may encounter challenges in discerning the intended message conveyed by the figure.