Related Experiment Video
Updated: Mar 30, 2026
11:05
SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
17.5K
The reliability of the Glasgow Coma Scale: a systematic review
Florence C M Reith1,2, Ruben Van den Brande3,4, Anneliese Synnot5,6,7
1Department of Neurosurgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium. florence.reith@uza.be.
Intensive Care Medicine
|November 14, 2015
Summary
The Glasgow Coma Scale (GCS) shows adequate reliability in high-quality studies, but overall study quality is often poor. Improving GCS assessment training and standardization is crucial for consistent results.
Area of Science:
- Neurology
- Critical Care Medicine
- Medical Measurement
Background:
- The Glasgow Coma Scale (GCS) is a standard tool for assessing consciousness levels.
- Its reliability is debated, impacting its use in research and clinical scoring systems.
Purpose of the Study:
- To systematically review and summarize evidence on the reliability of the Glasgow Coma Scale.
- To identify factors influencing GCS reliability and methodological quality of existing studies.
Main Methods:
- Conducted a systematic literature search across MEDLINE, EMBASE, and CINAHL.
- Included observational studies reporting GCS reliability with statistical measures.
- Assessed methodological quality using the consensus-based standards for the selection of health measurement instruments checklist.
Main Results:
- Analyzed 52 studies with significant heterogeneity in methods and populations.
- Good quality studies demonstrated high reliability (kappa ≥0.6 in 85%, excellent ICCs).
- Poor quality studies reported lower reliability; GCS components were more reliable than the sum score.
Conclusions:
- Only 13% of reviewed studies were of good methodological quality.
- While reliability is adequate in good studies, overall quality needs improvement.
- Enhanced training, education, and standardized assessment are recommended for clinical practice.
