The Italian version of the Coma Recovery Scale-Revised (CRS-R)

We present, in the appendix, the Italian version of the Coma Recovery Scale-Revised (CRS-R), a reliable tool that can distinguish patients in the minimally conscious state from those in a vegetative state. The CRS-R consists of 29 hierarchically organised items divided into 6 subscales addressing auditory, visual, motor, oromotor, communication, and arousal processes. The translation procedure, designed to ensure the development of an Italian version of the CRS-R that mirrors the structure and content of the original, was the following: three translations of the scale were concurrently completed by authors from the groups involved in the study; a selected version underwent back translation to detect errors in translation and to ensure that there was no misinterpretation of administration and scoring guidelines; a consensus meeting was held to agree on a fully comprehensible and accurate Italian translation that was consistent with the original English text; the authors of the original version were consulted for additional assistance with translation when consensus could not be reached; a final back translation was done based on the agreed Italian version. The Italian version of the scale is now available for use in clinical practice and in studies designed to investigate its psychometric properties; this will help in the coordination of multicentre studies to assess its reliability.