The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.
OBJECTIVE
To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R).


METHODS
Analysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy.


METHODS
Acute inpatient brain injury rehabilitation hospital.


METHODS
Convenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS).


METHODS
Not applicable.


METHODS
The CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS).


RESULTS
Interrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS.


CONCLUSIONS
The CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS.
Giacino
Joseph T
JT
JFK Johnson Rehabilitation Institute and New Jersey Neuroscience Institute, JFK Medical Center, Edison, NJ 08820, USA. jgiacino@solarishs.org
Kalmar
Kathleen
K
Whyte
John
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000503:physiopathology*; D011594:Psychometrics; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D012494:Sampling Studies; D015599:Trauma Severity Indices; D014481:United States