title: Validation of the Italian version of the Coma Recovery Scale-Revised (CRS-R).
abstract: OBJECTIVE
  To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R).
  
  
  METHODS
  Two observers applied the Italian version of the CRS-R to selected patients. On day 1, observer A and B independently scored each patient; the comparison of their observations was used to evaluate inter-observer agreement. On day 2, observer A completed a second evaluation and the comparison of this observation with that obtained on day 1 by the same observer was used to evaluate test-re-test agreement. For each evaluation, also diagnostic impression (vegetative state/minimally conscious state) was reported.
  
  
  RESULTS
  Thirty-eight patients were evaluated (mean age ± SD, 58.9 ± 13.8 years). Inter-observer (ρ = 0.81; p < 0.001) as well as test-re-test agreement (ρ = 0.97; p < 0.001) for the total score was high. Inter-observer agreement was excellent for the communication sub-scale, good for the auditory, visual and motor sub-scales and moderate for the oromotor/verbal and arousal sub-scales. Test-re-test agreement was excellent for the visual, motor, oromotor/verbal and communication sub-scales, good for the auditory sub-scale and moderate for the arousal sub-scale. When considering the diagnostic impression, inter-observer agreement was good (κ = 0.75; p < 0.001) and test-re-test agreement was excellent (κ = 0.92; p < 0.001).
  
  
  CONCLUSIONS
  The Italian version of the CRS-R can be administered reliably and can be also employed to discriminate patients in vegetative and in minimally conscious state.
authors.affiliation: Department of Neurology, University of L'Aquila, Piazzale Salvatore Tommasi 1, L'Aquila, Italy. simona.sacco@cc.univaq.it
authors.forename: Simona
authors.initials: S
authors.lastname: Sacco
authors.forename: Emma
authors.initials: E
authors.lastname: Altobelli
authors.forename: Caterina
authors.initials: C
authors.lastname: Pistarini
authors.forename: Davide
authors.initials: D
authors.lastname: Cerone
authors.forename: Benedetta
authors.initials: B
authors.lastname: Cazzulani
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
mesh_terms: D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000503:physiopathology; D003128:Coma / Q000145:classification / Q000503:physiopathology*; D003243:Consciousness / Q000145:classification / Q000502:physiology*; D005260:Female; D006801:Humans; D007558:Italy; D007802:Language; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D020127:Recovery of Function / Q000502:physiology*; D015599:Trauma Severity Indices