期刊
ANNALS OF PHYSICAL AND REHABILITATION MEDICINE
卷 64, 期 5, 页码 -出版社
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.rehab.2020.09.001
关键词
Coma; Disorders of consciousness; Trauma; Rehabilitation
资金
- University and University Hospital of Liege
- French Speaking Community Concerted Research Action [ARC 12-17/01]
- Belgian National Funds for Scientific Research (F.R.S-FNRS)
- Generet funds
- King Baudouin Foundation
- Marie Sklodowska-Curie Actions [H2020-MSCA-IF-2016-ADOC-752686]
- European Union [945539]
- James McDonnell Foundation
- Mind Science Foundation
- IAP research network of the Belgian Government (Belgian Science Policy) [P7/06]
- European Commission
- Public Utility Foundation Universite Europeenne du Travail
- Fondazione Europea di Ricerca Biomedica
- BIAL Foundation
- AstraZeneca Foundation
- Belgian National Plan Cancer [139]
The study introduced a new tool, SECONDs, which is faster and showed substantial agreement compared to the gold standard CRS-R in assessing consciousness in individuals with DoC.
Background: The Coma Recovery Scale-Revised (CRS-R) is the gold standard to assess severely brain-injured patients with prolonged disorders of consciousness (DoC). However, the amount of time needed to complete this examination may limit its use in clinical settings. Objective. We aimed to validate a new faster tool to assess consciousness in individuals with DoC. Methods: This prospective validation study introduces the Simplified Evaluation of CONsciousness Disorders (SECONDs), a tool composed of 8 items: arousal, localization to pain, visual fixation, visual pursuit, oriented behaviors, command-following, and communication (both intentional and functional). A total of 57 individuals with DoC were assessed on 2 consecutive days by 3 blinded examiners: one CRS-R and one SECONDs were performed on 1 day, whereas 2 SECONDs were performed on the other day. A Mann-Whitney U test was used to compare the duration of administration of the SECONDs versus the CRS-R, and weighted Fleiss' kappa coefficients were used to assess inter-/intra-rater reliability as well as concurrent validity. Results: In the 57 participants, the SECONDs was about 2.5 times faster to administer than the CRS-R. The comparison of the CRS-R versus the SECONDs on the same day or the best of the 3 SECONDs led to substantial or almost perfect agreement (kappa coefficients ranging from 0.78 to 0.85). Intra-/inter-rater reliability also showed almost perfect agreement (kappa coefficients from 0.85 to 0.91 and 0.82 to 0.85, respectively). Conclusions: The SECONDs appears to be a fast, reliable and easy-to-use scale to diagnose DoC and may be a good alternative to other scales in clinical settings where time constraints preclude a more thorough assessment. (C) 2020 The Author(s). Published by Elsevier Masson SAS.
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