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Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group in the Pediatric
Varina L Boerwinkle1, Brian Appavu2, Emilio Garzon Cediel3
1Department of Neurology, University of North Carolina in Chapel Hill, Chapel Hill, NC, USA. Varina_Boerwinke@med.unc.edu.
Insights
Standardized terminology for pediatric disorders of consciousness (DoC) is crucial for research. This study introduces pediatric-specific common data elements (CDEs) to enable collaborative studies and advance evidenced-based care for children with DoC.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Developmental Neuroscience
Background:
- Lack of standardized terminology hinders comparative research in pediatric disorders of consciousness (DoC).
- Measuring consciousness in young children presents unique challenges, impeding progress in evidenced-based care.
- Advancements in clinical exams and biomarkers offer new ways to assess DoC in the developing brain.
Purpose of the Study:
- To establish consensus-based, pediatric-tailored common data elements (CDEs) for disorders of consciousness (DoC).
- To facilitate reliable measurement and comparative research in pediatric DoC.
- To support the development of evidenced-based care for neonates and children with DoC.
Main Methods:
- Convened an international, interdisciplinary panel of pediatric DoC experts under the Neurocritical Care Society's Curing Coma Campaign.
- Developed pediatric-tailored common data elements (CDEs) across key research domains.
- Included working groups on behavioral phenotyping, biospecimens, electrophysiology, family/goals of care, neuroimaging, outcomes, physiology, therapies, and pediatrics.
Main Results:
- Generated pediatric-focused recommendations for common data elements (CDEs) in DoC research.
- Disseminated these CDEs for application in studies involving pediatric patients with DoC.
- Provided a foundational set of standardized terms for pediatric DoC research.
Conclusions:
- Recommended CDEs facilitate collaborative and successful international research in pediatric coma.
- These standardized elements are essential for advancing the understanding and treatment of DoC in children.
- Supports the vision of improved evidenced-based care through shared research terminology.
Background:
The fundamental gap obstructing forward progress of evidenced-based care in pediatric and neonatal disorders of consciousness (DoC) is the lack of defining consensus-based terminology to perform comparative research. This lack of shared nomenclature in pediatric DoC stems from the inherently recursive dilemma of the inability to reliably measure consciousness in the very young. However, recent advancements in validated clinical examinations and technologically sophisticated biomarkers of brain activity linked to future abilities are unlocking this previously formidable challenge to understanding the DoC in the developing brain.
Methods:
To address this need, the first of its kind international convergence of an interdisciplinary team of pediatric DoC experts was organized by the Neurocritical Care Society's Curing Coma Campaign. The multidisciplinary panel of pediatric DoC experts proposed pediatric-tailored common data elements (CDEs) covering each of the CDE working groups including behavioral phenotyping, biospecimens, electrophysiology, family and goals of care, neuroimaging, outcome and endpoints, physiology and big Data, therapies, and pediatrics.
Results:
We report the working groups' pediatric-focused DoC CDE recommendations and disseminate CDEs to be used in studies of pediatric patients with DoC.
Conclusions:
The CDEs recommended support the vision of progressing collaborative and successful internationally collaborative pediatric coma research.
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