A French validation study of the Coma Recovery Scale-Revised (CRS-R).
OBJECTIVE
The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM).


METHODS
Multi-centric prospective study.


METHODS
To test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement.


RESULTS
Good concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM.


CONCLUSIONS
The results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff.
Schnakers
Caroline
C
Coma Science Group, Cyclotron Research Centre, University of Liège, Liège, Belgium. c.schnakers@student.ulg.ac.be
Majerus
Steve
S
Giacino
Joseph
J
Vanhaudenhuyse
Audrey
A
Bruno
Marie-Aurelie
MA
Boly
Melanie
M
Moonen
Gustave
G
Damas
Pierre
P
Lambermont
Bernard
B
Lamy
Maurice
M
Damas
Francois
F
Ventura
Manfredi
M
Laureys
Steven
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000175:diagnosis; D001930:Brain Injuries / Q000175:diagnosis*; D003128:Coma / Q000175:diagnosis; D003243:Consciousness / Q000502:physiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015588:Observer Variation; D018458:Persistent Vegetative State / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012680:Sensitivity and Specificity; D015599:Trauma Severity Indices