title: A study of the reliability of the Nociception Coma Scale.
abstract: OBJECTIVE
  In this study, we investigated the reliability of the Nociception Coma Scale which has recently been developed to assess nociception in non-communicative, severely brain-injured patients.
  
  
  METHODS
  Prospective cross-sequential study.
  
  
  METHODS
  Semi-intensive care unit and long-term brain injury care.
  
  
  METHODS
  Forty-four patients diagnosed as being in a vegetative state (n=26) or in a minimally conscious state (n=18).
  
  
  METHODS
  Patients were assessed by two experts (rater A and rater B) on two consecutive weeks to measure inter-rater agreement and test-retest reliability.
  
  
  METHODS
  Total scores and subscores of the Nociception Coma Scale.
  
  
  RESULTS
  We performed a total of 176 assessments. The inter-rater agreement was moderate for the total scores (k = 0.57) and fair to substantial for the subscores (0.33 ≤ k ≤ 0.62) on week 2. The test-retest reliability was substantial for the total scores (k = 0.66) and moderate to almost perfect for the subscores (0.53 ≤ k ≤ 0.96) for rater A. The inter-rater agreement was weaker on week 1, whereas the test-retest reliability was lower for the least experienced rater (rater B).
  
  
  CONCLUSIONS
  This study provides further evidence of the psychometric qualities of the Nociception Coma Scale. Future studies should assess the impact of practical experience and background on administration and scoring of the scale.
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy f.riganello@istitutosantanna.it.
authors.forename: F
authors.initials: F
authors.lastname: Riganello
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy.
authors.forename: M D
authors.initials: MD
authors.lastname: Cortese
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Arcuri
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Candelieri
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Guglielmino
authors.affiliation: Research in Advanced Neurorehabilitation, S. Anna Institute, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Dolce
authors.affiliation: Department of Neuroscience, Ophthalmology and Genetics, University of Genova, Genova, Italy Department of Psychiatry, State University of New York, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Sannita
authors.affiliation: Coma Science Group, Cyclotron Research Center, University of Liege, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Schnakers
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D003128:Coma / Q000150:complications / Q000523:psychology*; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059225:Nociception / Q000502:physiology*; D059226:Nociceptive Pain / Q000175:diagnosis*; D015588:Observer Variation; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results
keywords: Brain injury; minimally conscious state; nociception; pain; vegetative state