Feasibility and Validity of the Coma Recovery Scale-Revised for Accelerated Standardized Testing: A Practical Assessment Tool for Detecting Consciousness in the Intensive Care Unit.
Bodien, Yelena G; Vora, Isha; Barra, Aliceet al.
2023 • In Annals of Neurology, 94 (5), p. 919 - 924
Humans; Reproducibility of Results; Feasibility Studies; Recovery of Function; Intensive Care Units; Consciousness Disorders/diagnosis; Coma/diagnosis; Consciousness; Coma; Consciousness Disorders; Neurology; Neurology (clinical)
Abstract :
[en] We developed and validated an abbreviated version of the Coma Recovery Scale-Revised (CRS-R), the CRS-R For Accelerated Standardized Testing (CRSR-FAST), to detect conscious awareness in patients with severe traumatic brain injury in the intensive care unit. In 45 consecutively enrolled patients, CRSR-FAST administration time was approximately one-third of the full-length CRS-R (mean [SD] 6.5 [3.3] vs 20.1 [7.2] minutes, p < 0.0001). Concurrent validity (simple kappa 0.68), test-retest (Mak's ρ = 0.76), and interrater (Mak's ρ = 0.91) reliability were substantial. Sensitivity, specificity, and accuracy for detecting consciousness were 81%, 89%, and 84%, respectively. The CRSR-FAST facilitates serial assessment of consciousness, which is essential for diagnostic and prognostic accuracy. ANN NEUROL 2023;94:919-924.
Disciplines :
Neurology
Author, co-author :
Bodien, Yelena G ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Vora, Isha; Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
Barra, Alice ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
Chiang, Kevin; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
Chatelle, Camille ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
Goostrey, Kelsey; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
Martens, Géraldine ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Department of Surgery, University of Montréal, Montréal, QC, Canada
Malone, Christopher; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
Mello, Jennifer; Department of Speech-language and Swallowing, Massachusetts General Hospital, Boston, MA, USA
Parlman, Kristin; Department of Physical Therapy, Massachusetts General Hospital, Boston, MA, USA
Ranford, Jessica; Department of Occupational Therapy, Massachusetts General Hospital Boston, Boston, MA, USA
Sterling, Ally; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
Waters, Abigail B; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
Hirschberg, Ronald; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Katz, Douglas I; Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA ; Encompass Health Braintree Rehabilitation, Braintree, MA, USA
Mazwi, Nicole; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA ; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
Ni, Pengsheng; Biostatistics & Epidemiology Data Analytic Center, Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
Velmahos, George; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
Waak, Karen; Department of Physical Therapy, Massachusetts General Hospital, Boston, MA, USA
Edlow, Brian L ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA ; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
Giacino, Joseph T; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA ; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Feasibility and Validity of the Coma Recovery Scale-Revised for Accelerated Standardized Testing: A Practical Assessment Tool for Detecting Consciousness in the Intensive Care Unit.
JSMF - James S McDonnell Foundation NINDS - National Institute of Neurological Disorders and Stroke NIDILRR - National Institute on Disability, Independent Living, and Rehabilitation Research Tiny Blue Dot Foundation
Funding text :
The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPTB0011; Spaulding Rehabilitation Hospital). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and endorsement by the Federal Government should not be assumed. Y.G.B. receives funding from NIH National Institute of Neurological Disorders and Stroke (U01 NS1365885, U01‐NS086090), National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living (90DPCP0008‐01‐00, 90DP0039), James S. McDonnell Foundation, and Tiny Blue Dot Foundation. G.M. reports funding from National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), the European Union's Horizon 2020 Framework Program for Research and Innovation under the Specific Grant Agreement 686764 (Luminous project), the Foundation Léon Fredericq, the ULiège Foundation, the Fédération Wallonie‐Bruxelles, and Wallonie‐Bruxelles International (WBI.World Program). C.C. reports funding from The Belgian American Foundation, The Marie Sklodowska‐Curie Actions (H2020‐MSCA‐IF‐2016‐ADOC‐752686), and Wallonie‐Bruxelles International. B.L.E. received funding from the NIH Director's Office (DP2HD101400), James S. McDonnell Foundation, and Tiny Blue Dot Foundation. J.T.G receives funding from National Institutes of Health, National Institute of Neurologic Disorders and Stroke (U01 NS1365885), National Institute on Disability, Independent Living, and Rehabilitation Research, and U.S. Department of Defense (# W81XWH‐14‐2‐0176, MTEC‐18‐03‐DTTBI‐0001).The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPTB0011; Spaulding Rehabilitation Hospital). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and endorsement by the Federal Government should not be assumed. Y.G.B. receives funding from NIH National Institute of Neurological Disorders and Stroke (U01 NS1365885, U01-NS086090), National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living (90DPCP0008-01-00, 90DP0039), James S. McDonnell Foundation, and Tiny Blue Dot Foundation. G.M. reports funding from National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), the European Union's Horizon 2020 Framework Program for Research and Innovation under the Specific Grant Agreement 686764 (Luminous project), the Foundation Léon Fredericq, the ULiège Foundation, the Fédération Wallonie-Bruxelles, and Wallonie-Bruxelles International (WBI.World Program). C.C. reports funding from The Belgian American Foundation, The Marie Sklodowska-Curie Actions (H2020-MSCA-IF-2016-ADOC-752686), and Wallonie-Bruxelles International. B.L.E. received funding from the NIH Director's Office (DP2HD101400), James S. McDonnell Foundation, and Tiny Blue Dot Foundation. J.T.G receives funding from National Institutes of Health, National Institute of Neurologic Disorders and Stroke (U01 NS1365885), National Institute on Disability, Independent Living, and Rehabilitation Research, and U.S. Department of Defense (# W81XWH-14-2-0176, MTEC-18-03-DTTBI-0001).
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