OBJECTIVES: (1) To appraise, by the means of Rasch analysis, the internal validity and reliability of the Coma Recovery Scale-Revised (CRS-R) in a sample of patients with disorder of consciousness (DOC); and (2) to provide information about the comparability of CRS-R scores across persons with DOC across different settings and groups, including different etiologies. DESIGN: Multicenter observational prospective study. SETTING: Two rehabilitation wards, 1 intermediate care facility, and 2 nursing homes in Italy. PARTICIPANTS: Consecutively admitted patients (N=129) for which assessments at 2 different time points were available, giving a total sample of 258 observations. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: CRS-R. RESULTS: After controlling for any possible dependency between persons' measures collected at different time points, and for uniform differential item functioning by etiology showed by the visual subscale, Rasch analysis demonstrated adequate satisfaction of all the model's requirements, including adequate ordering of scoring categories, unidimensionality, local independence, invariance (χ(2)21=27.798, P=.146), and absence of differential item functioning across patients' sex, age, time, and setting. The reliability (person separation index=.896) was adequate for individual person measurement. We devised a practical raw score to measure conversion tables based on the CRS-R calibrations. CONCLUSIONS: The CRS-R is a psychometrically sound and robust measurement tool. The linear measures of ability derived from the CRS-R total scores do satisfy all the principles of scientific measurement and are sufficiently reliable for high stakes assessments, such as the diagnosis of the level of consciousness in individual patients. Future studies are needed to directly explore the capabilities of the CRS-R measures to reduce the risk of vegetative state misdiagnosis.
OBJECTIVES: (1) To appraise, by the means of Rasch analysis, the internal validity and reliability of the Coma Recovery Scale-Revised (CRS-R) in a sample of patients with disorder of consciousness (DOC); and (2) to provide information about the comparability of CRS-R scores across persons with DOC across different settings and groups, including different etiologies. DESIGN: Multicenter observational prospective study. SETTING: Two rehabilitation wards, 1 intermediate care facility, and 2 nursing homes in Italy. PARTICIPANTS: Consecutively admitted patients (N=129) for which assessments at 2 different time points were available, giving a total sample of 258 observations. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: CRS-R. RESULTS: After controlling for any possible dependency between persons' measures collected at different time points, and for uniform differential item functioning by etiology showed by the visual subscale, Rasch analysis demonstrated adequate satisfaction of all the model's requirements, including adequate ordering of scoring categories, unidimensionality, local independence, invariance (χ(2)21=27.798, P=.146), and absence of differential item functioning across patients' sex, age, time, and setting. The reliability (person separation index=.896) was adequate for individual person measurement. We devised a practical raw score to measure conversion tables based on the CRS-R calibrations. CONCLUSIONS: The CRS-R is a psychometrically sound and robust measurement tool. The linear measures of ability derived from the CRS-R total scores do satisfy all the principles of scientific measurement and are sufficiently reliable for high stakes assessments, such as the diagnosis of the level of consciousness in individual patients. Future studies are needed to directly explore the capabilities of the CRS-R measures to reduce the risk of vegetative state misdiagnosis.
Authors: John C O'Donnell; Kevin D Browne; Todd J Kilbaugh; H Isaac Chen; John Whyte; D Kacy Cullen Journal: Neurosci Biobehav Rev Date: 2018-12-11 Impact factor: 8.989
Authors: Jennifer A Weaver; Alison M Cogan; Katherine A O'Brien; Piper Hansen; Joseph T Giacino; John Whyte; Theresa Bender Pape; Philip van der Wees; Trudy Mallinson Journal: J Neurotrauma Date: 2022-06-16 Impact factor: 4.869
Authors: Camille Chatelle; Yelena G Bodien; Cecilia Carlowicz; Sarah Wannez; Vanessa Charland-Verville; Olivia Gosseries; Steven Laureys; Ron T Seel; Joseph T Giacino Journal: Arch Phys Med Rehabil Date: 2016-03-02 Impact factor: 3.966
Authors: Giulio E Lancioni; Andrea Bosco; Marta Olivetti Belardinelli; Nirbhay N Singh; Mark F O'Reilly; Jeff Sigafoos; Francesca Buonocunto; Jorge Navarro; Crocifissa Lanzilotti; Fiora D'Amico; Marina De Tommaso Journal: Front Hum Neurosci Date: 2014-02-10 Impact factor: 3.169