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Rasch Analysis of the Chinese Version of the Nociception Coma Scale-Revised in Patients with Prolonged Disorders of
Yuhang Zheng1, Xinyou Lin1, Yuehong Huang1
1International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.
Objectives:
The aim of this study was to analyze the Chinese version of the Nociception Coma Scale-Revised in patients with prolonged disorders of consciousness within the framework of Rasch modeling, including investigating the invariance of total scores across different etiologies of disorders of consciousness.
Design:
Prospective psychometric study.
Participants:
Patients with prolonged disorders of consciousness from the Rehabilitation and Neurology units in hospital.
Interventions:
None.
Main Outcome Measure:
The Nociception Coma Scale-Revised was undertaken by trained raters and the Coma Recovery Scale-Revised was used to assess patients' consciousness. The psychometric properties within the Rasch model including item-person targeting, reliability and separation, item fit, unidimensionality, and differential item functioning were assessed.
Results:
84 patients with prolonged disorders of consciousness (mean age 53 years; mean injury 5 months; 42 with Minimally Conscious State and 42 with Unresponsive Wakefulness Syndrome) of 252 observations were enrolled in the study. Through the procedure of repeated assessment and differential item function, a lower item bias Rasch set was purified. The Rasch model assumptions were examined and met, with item reliability and validity meeting the recommended threshold.
Conclusions:
The Chinese version of the Nociception Coma Scale-Revised demonstrated unidimensionality, good reliability and separation, and good item fit, but dissatisfied person fit and item-person targeting. The verbal subscale showed a notable discrepancy between person responses and the difficulty of the items, suggesting limited clinical significance.
