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Updated: May 11, 2026

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
The Recovery of Consciousness via Evidence-Based Medicine and Research (RECOVER) Program: A Paradigm for Advancing
David Fischer1, Benjamin S Abella1, Geoffrey D Bass1
1Division of Neurocritical Care (DF, JML), Department of Neurology; Department of Emergency Medicine (BSA); Division of Pulmonary, Allergy and Critical Care (GDB, OJM), Department of Medicine; Department of Physical Medicine and Rehabilitation (JC, SH); Division of Epilepsy (CVK-S, SRS, GJW), Department of Neurology; Department of Palliative Care (MTM); Ethics (AMN), Perelman School of Medicine, University of Pennsylvania; Physical Therapy (WP), Good Shepherd Penn Partners at the Hospital of the University of Pennsylvania; Clinical Resource Management and Social Work (MLS), Hospital of the University of Pennsylvania; and Division of Neuroradiology (JBW), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Background:
Neuroprognostication for disorders of consciousness (DoC) after severe acute brain injury is a major challenge, and the conventional clinical approach struggles to keep pace with a rapidly evolving literature. Lacking specialization, and fragmented between providers, conventional neuroprognostication is variable, frequently incongruent with guidelines, and prone to error, contributing to avoidable mortality and morbidity.
Recent Findings:
We review the limitations of the conventional approach to neuroprognostication and DoC care, and propose a paradigm entitled the Recovery of Consciousness Via Evidence-Based Medicine and Research (RECOVER) program to address them. The aim of the RECOVER program is to provide specialized, comprehensive, and longitudinal care that synthesizes interdisciplinary perspectives, provides continuity to patients and families, and improves the future of DoC care through research and education.
Implications For Practice:
This model, if broadly adopted, may help establish neuroprognostication as a new subspecialty that improves the care of this vulnerable patient population.
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