The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility |
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Authors: | Giacino Joseph T Kalmar Kathleen Whyte John |
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Institution: | a JFK Johnson Rehabilitation Institute and New Jersey Neuroscience Institute, JFK Medical Center, Edison, NJ, USA b Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, and Thomas Jefferson University, Philadelphia, PA, USA |
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Abstract: | Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.ObjectiveTo determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R).DesignAnalysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy.SettingAcute inpatient brain injury rehabilitation hospital.ParticipantsConvenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS).InterventionsNot applicable.Main outcome measuresThe CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS).ResultsInterrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS.ConclusionsThe CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS. |
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Keywords: | Coma Minimally conscious state Outcome assessment (health care) Persistent vegetative state Rehabilitation |
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