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- Title
A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.
- Authors
Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Sebastiano, Davide Rossi; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde
- Abstract
Objective: The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Design: Cross sectional design/methodological study. Setting: Inpatient, neurological unit. Participants: A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. Intervention: All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Main outcome measures: Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Results: Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. Conclusion: The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.
- Subjects
BRAIN injuries; CONFIDENCE intervals; FACTOR analysis; LOSS of consciousness; MEDICAL needs assessment; PROBABILITY theory; RESEARCH funding; STATISTICS; PERSISTENT vegetative state; DATA analysis; EFFECT sizes (Statistics); CROSS-sectional method; RECEIVER operating characteristic curves; RESEARCH methodology evaluation; DATA analysis software; MANN Whitney U Test; KRUSKAL-Wallis Test
- Publication
Clinical Rehabilitation, 2017, Vol 31, Issue 9, p1226
- ISSN
0269-2155
- Publication type
Article
- DOI
10.1177/0269215517694225