title: An Italian multicentre validation study of the coma recovery scale-revised.
abstract: BACKGROUND
  Rate of misdiagnosis of disorders of consciousness (DoC) can be reduced by employing validated clinical diagnostic tools, such as the Coma Recovery Scale-Revised (CRS-R). An Italian version of the CRS-R has been recently developed, but its applicability across different clinical settings, and its concurrent validity and diagnostic sensitivity have not been estimated yet.
  
  
  OBJECTIVE
  To perform a multicentre validation study of the Italian version of the Coma Recovery Scale-Revised (CRS-R).
  
  
  METHODS
  Analysis of inter-rater reliability, concurrent validity and diagnostic sensitivity of the scale.
  
  
  METHODS
  One Intensive Care Unit, 8 Post-acute rehabilitation centres and 2 Long-term facilities
  
  
  METHODS
  Twenty-seven professionals (physicians, N.=11; psychologists, N.=5; physiotherapists, N.=3; speech therapists, N.=6; nurses, N.=2) from 11 Italian Centres.
  
  
  METHODS
  CRS-R and Disability Rating Scale (DRS) applied to 122 patients with clinical diagnosis of Vegetative State (VS) or Minimally Conscious State (MCS).
  
  
  RESULTS
  CRS-R has good-to-excellent inter-rater reliability for all subscales, particularly for the communication subscale. The Italian version of the CRS-R showed a high sensitivity and specificity in detecting MCS with reference to clinical consensus diagnosis. The CRS-R showed good concurrent validity with the Disability Rating Scale, which had very low specificity with reference to clinical consensus diagnosis.
  
  
  CONCLUSIONS
  The Italian version of the CRS-R is a valid scale for use from the sub-acute to chronic stages of DoC. It can be administered reliably by all members of the rehabilitation team with different specialties, levels of experience and settings.
  
  
  CONCLUSIONS
  The present study promote use of the Italian version of the CRS-R to improve diagnosis of DoC patients, and plan tailored rehabilitation treatment.
authors.affiliation: Disorders of Consciousness Laboratory, Salvatore Maugeri Foundation, IRCCS Scientific Institute, Telese Terme, Benevento, Italy - anna.estraneo@fsm.it.
authors.forename: A
authors.initials: A
authors.lastname: Estraneo
authors.forename: P
authors.initials: P
authors.lastname: Moretta
authors.forename: A
authors.initials: A
authors.lastname: De Tanti
authors.forename: G
authors.initials: G
authors.lastname: Gatta
authors.forename: J T
authors.initials: JT
authors.lastname: Giacino
authors.forename: L
authors.initials: L
authors.lastname: Trojano
mesh_terms: D003128:Coma / Q000175:diagnosis* / Q000503:physiopathology* / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007318:Inservice Training; D007558:Italy; D008297:Male; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity