ABSTRACT
Primary Objective: This study aims to validate the Chinese version of the Coma Recovery Scale-Revised (CRS-R).
Methods: One hundred sixty-nine patients were assessed with both the CRS-R and the Glasgow Coma Scale (GCS), diagnosed as being in unresponsive wakefulness syndrome (UWS, formerly known as vegetative state), minimally conscious state (MCS), or emergence from MCS (EMCS). A subgroup of 50 patients has been assessed twice by the same rater, within 24 h. Patient outcome was documented six months after assessment.
Results: The internal consistency for the CRS-R total score was excellent (Cronbach’s α = 0.84). Good test–retest reliability was obtained for CRS-R total score and subscale scores (intra-class correlation coefficient [ICC] = 0.87 and ICC = 0.66–0.84, respectively). Inter-rater reliability was high (ICC = 0.719; p < 0.01). Concurrent validity was good between CRS-R total scale and GCS total scale. Diagnostic validity was excellent compared with GCS (emerged from UWS: 24%; emerged from MCS: 28%). When considering patient outcome, diagnostic validity was good. In addition, false-positive rates have been detected for both diagnoses.
Conclusion: The Chinese version of the CRS-R is a reliable and sensitive tool and can discriminate patients in UWS, MCS, and EMCS successfully.
Acknowledgments
We greatly appreciate the statistical advices provided by Jiqian Fang.
Disclosure of interest
The authors report no conflict of interest.
Supplementary material
Supplementary data can be accessed here.