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Published on: October 5, 2020
Validation of the Chinese version of the Coma Recovery Scale-Revised (CRS-R)
Ying Zhang1,2, Jing Wang1, Caroline Schnakers3,4
1a International Vegetative State and Consciousness Science Institute, Hangzhou Normal University , Hangzhou , Zhejiang , China.
Primary Objective:
This study aims to validate the Chinese version of the Coma Recovery Scale-Revised (CRS-R).
Methods:
One hundred sixty-nine patients were assessed with both the CRS-R and the Glasgow Coma Scale (GCS), diagnosed as being in unresponsive wakefulness syndrome (UWS, formerly known as vegetative state), minimally conscious state (MCS), or emergence from MCS (EMCS). A subgroup of 50 patients has been assessed twice by the same rater, within 24 h. Patient outcome was documented six months after assessment.
Results:
The internal consistency for the CRS-R total score was excellent (Cronbach's α = 0.84). Good test-retest reliability was obtained for CRS-R total score and subscale scores (intra-class correlation coefficient [ICC] = 0.87 and ICC = 0.66-0.84, respectively). Inter-rater reliability was high (ICC = 0.719; p < 0.01). Concurrent validity was good between CRS-R total scale and GCS total scale. Diagnostic validity was excellent compared with GCS (emerged from UWS: 24%; emerged from MCS: 28%). When considering patient outcome, diagnostic validity was good. In addition, false-positive rates have been detected for both diagnoses.
Conclusion:
The Chinese version of the CRS-R is a reliable and sensitive tool and can discriminate patients in UWS, MCS, and EMCS successfully.
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