Paul Gerrard1, Ross Zafonte1, Joseph T Giacino2. 1. Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA. 2. Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA. Electronic address: jgiacino@partners.org.
Abstract
OBJECTIVE: To investigate the neurobehavioral pattern of recovery of consciousness as reflected by performance on the subscales of the Coma Recovery Scale-Revised (CRS-R). DESIGN: Retrospective item response theory (IRT) and factor analysis. SETTING: Inpatient rehabilitation facilities. PARTICIPANTS: Rehabilitation inpatients (N=180) with posttraumatic disturbance in consciousness who participated in a double-blinded, randomized, controlled drug trial. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Scores on CRS-R subscales. RESULTS: The CRS-R was found to fit factor analytic models adhering to the assumptions of unidimensionality and monotonicity. In addition, subscales were mutually independent based on residual correlations. Nonparametric IRT reaffirmed the finding of monotonicity. A highly constrained confirmatory factor analysis model, which imposed equal factor loadings on all items, was found to fit the data well and was used to estimate a 1-parameter IRT model. CONCLUSIONS: This study provides evidence of the unidimensionality of the CRS-R and supports the hierarchical structure of the CRS-R subscales, suggesting that it is an effective tool for establishing diagnosis and monitoring recovery of consciousness after severe traumatic brain injury.
RCT Entities:
OBJECTIVE: To investigate the neurobehavioral pattern of recovery of consciousness as reflected by performance on the subscales of the Coma Recovery Scale-Revised (CRS-R). DESIGN: Retrospective item response theory (IRT) and factor analysis. SETTING: Inpatient rehabilitation facilities. PARTICIPANTS: Rehabilitation inpatients (N=180) with posttraumatic disturbance in consciousness who participated in a double-blinded, randomized, controlled drug trial. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Scores on CRS-R subscales. RESULTS: The CRS-R was found to fit factor analytic models adhering to the assumptions of unidimensionality and monotonicity. In addition, subscales were mutually independent based on residual correlations. Nonparametric IRT reaffirmed the finding of monotonicity. A highly constrained confirmatory factor analysis model, which imposed equal factor loadings on all items, was found to fit the data well and was used to estimate a 1-parameter IRT model. CONCLUSIONS: This study provides evidence of the unidimensionality of the CRS-R and supports the hierarchical structure of the CRS-R subscales, suggesting that it is an effective tool for establishing diagnosis and monitoring recovery of consciousness after severe traumatic brain injury.
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: Jean-Michel Pignat; Etienne Mauron; Jane Jöhr; Charlotte Gilart de Keranflec'h; Dimitri Van De Ville; Maria Giulia Preti; Djalel E Meskaldji; Volker Hömberg; Steven Laureys; Bogdan Draganski; Richard Frackowiak; Karin Diserens Journal: PLoS One Date: 2016-06-30 Impact factor: 3.240