Feasibility and Validity of the Coma Recovery Scale‐Revised for Accelerated Standardized Testing: A Practical Assessment Tool for Detecting Consciousness in the Intensive Care Unit
Yelena G. Bodien, Isha Vora, Alice Barra, Kevin C.H. Chiang, Camille Chatelle, Kelsey Goostrey, Géraldine Martens, Christopher Malone, Jennifer Mello, Kristin Parlman, Jessica Ranford, Ally Sterling, Abigail B. Waters, Ronald E. Hirschberg, Douglas I. Katz, Nicole Mazwi, Pengsheng Ni, George C. Velmahos, Karen Waak, Brian L. Edlow, Joseph T. Giacino
Abstract
We developed and validated an abbreviated version of the Coma Recovery Scale-Revised (CRS-R), the CRS-R For Accelerated Standardized Testing (CRSR-FAST), to detect conscious awareness in patients with severe traumatic brain injury in the intensive care unit. In 45 consecutively enrolled patients, CRSR-FAST administration time was approximately one-third of the full-length CRS-R (mean [SD] 6.5 [3.3] vs 20.1 [7.2] minutes, p < 0.0001). Concurrent validity (simple kappa 0.68), test-retest (Mak's ρ = 0.76), and interrater (Mak's ρ = 0.91) reliability were substantial. Sensitivity, specificity, and accuracy for detecting consciousness were 81%, 89%, and 84%, respectively. The CRSR-FAST facilitates serial assessment of consciousness, which is essential for diagnostic and prognostic accuracy. ANN NEUROL 2023;94:919-924.