Article (Scientific journals)
Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores
Chatelle, Camille; Bodien, Y. G.; Carlowicz, C. et al.
2016In Archives of Physical Medicine and Rehabilitation, 97 (8), p. 1295-1300.e4
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Keywords :
Brain injuries; Consciousness disorders; Outcome assessment (health care); Rehabilitation; Adult; Arousal; Communication; Female; Hearing Tests; Humans; Male; Middle Aged; Motor Activity; Physical Therapy Modalities; Recovery of Function; Retrospective Studies; Trauma Severity Indices; Vision Tests
Abstract :
[en] Objective To determine the frequency with which specific Coma Recovery Scale-Revised (CRS-R) subscale scores co-occur as a means of providing clinicians and researchers with an empirical method of assessing CRS-R data quality. Design We retrospectively analyzed CRS-R subscale scores in hospital inpatients diagnosed with disorders of consciousness (DOCs) to identify impossible and improbable subscore combinations as a means of detecting inaccurate and unusual scores. Impossible subscore combinations were based on violations of CRS-R scoring guidelines. To determine improbable subscore combinations, we relied on the Mahalanobis distance, which detects outliers within a distribution of scores. Subscore pairs that were not observed at all in the database (ie, frequency of occurrence=0%) were also considered improbable. Setting Specialized DOC program and university hospital. Participants Patients diagnosed with DOCs (N=1190; coma: n=76, vegetative state: n=464, minimally conscious state: n=586, emerged from minimally conscious state: n=64; 794 men; mean age, 43±20y; traumatic etiology: n=747; time postinjury, 162±568d). Interventions Not applicable. Main Outcome Measure Impossible and improbable CRS-R subscore combinations. Results Of the 1190 CRS-R profiles analyzed, 4.7% were excluded because they met scoring criteria for impossible co-occurrence. Among the 1137 remaining profiles, 12.2% (41/336) of possible subscore combinations were classified as improbable. Conclusions Clinicians and researchers should take steps to ensure the accuracy of CRS-R scores. To minimize the risk of diagnostic error and erroneous research findings, we have identified 9 impossible and 36 improbable CRS-R subscore combinations. The presence of any one of these subscore combinations should trigger additional data quality review. © 2016 American Congress of Rehabilitation Medicine
Disciplines :
Neurosciences & behavior
Author, co-author :
Chatelle, Camille ;  Université de Liège - ULiège > GIGA : Coma Group
Bodien, Y. G.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
Carlowicz, C.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
Wannez, Sarah ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Charland-Verville, Vanessa ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Gosseries, Olivia  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Laureys, Steven  ;  Université de Liège - ULiège > GIGA : Coma Group
Seel, R. T.;  Crawford Research Institute, Shepherd Center, Atlanta, GA, United States
Giacino, J. T.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
Language :
English
Title :
Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores
Publication date :
2016
Journal title :
Archives of Physical Medicine and Rehabilitation
ISSN :
0003-9993
eISSN :
1532-821X
Publisher :
W.B. Saunders
Volume :
97
Issue :
8
Pages :
1295-1300.e4
Peer reviewed :
Peer Reviewed verified by ORBi
Name of the research project :
NIDILRR Grant 90DP0039-01-00
Funders :
NIDILRR - National Institute on Disability, Independent Living, and Rehabilitation Research [US-WA] [US-WA]
JSMF - James S McDonnell Foundation [US-MO] [US-MO]
Harvard University [US-MA] [US-MA]
BAEF - Belgian American Educational Foundation [BE]
WBI - Wallonie-Bruxelles International [BE]
F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE]
CE - Commission Européenne [BE]
FERB - Fondazione Europea Ricerca Biomedica [IT]
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