Ying Zhang1,2, Jing Wang1, Caroline Schnakers3,4, Minhui He1,2, Hong Luo2, Lijuan Cheng1,5, Fuyan Wang1,2, Yunzhi Nie1,6, Wangshan Huang1, Xiaohua Hu7, Steven Laureys8, Haibo Di1. 1. a International Vegetative State and Consciousness Science Institute, Hangzhou Normal University , Hangzhou , Zhejiang , China. 2. b The Affiliated Hospital of Hangzhou Normal University , Hangzhou Normal University , Hangzhou , Zhejiang , China. 3. c Research Institute , Casa Colina Hospital and Centers for Healthcare , Pomona , CA , USA. 4. d Department of Psychiatry , University of California , Los Angeles , CA , USA. 5. e Hangzhou Normal University Qianjiang College , Hangzhou , Zhejiang , China. 6. f Ningbo NO.7 Hospital , Ningbo , Zhejiang , China. 7. g Department of Rehabilitation , Hangzhou Wujing Hospital , Hangzhou , China. 8. h GIGA, GIGA-Consciousness, Coma Science Group, University & Neurology Department , Hospital of Liege , Liege , Belgium.
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.
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.