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Updated: Jan 14, 2026
SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
Clinical Validation of the SECONDs Tool for Evaluating Disorders of Consciousness in Argentina
María Julieta Russo1,2, María de la Paz Sampayo3, Paula Arias4
1Dirección Docencia e Investigación, Santa Catalina Neurorehabilitación Clínica, Buenos Aires C1060AAF, Argentina.
Background:
The Coma Recovery Scale-Revised (CRS-R) is the gold standard for diagnosing chronic disorders of consciousness (DoC); however, its clinical utility is limited by lengthy administration and the need for specialized training. The Simplified Evaluation of Disorders of Consciousness (SECONDs) provides a faster and more user-friendly alternative.
Objective:
This study aims to evaluate the validity and reliability of the Argentine adaptation of the SECONDs scale in adults with chronic DoC due to acquired brain injury.
Methods:
Twenty-nine patients were evaluated over two consecutive days by three blinded raters. On day one, rater A administered the SECONDs (A1) and rater B administered the CRS-R (B) to assess concurrent validity. On day two, rater A repeated the SECONDs (A2), and rater C performed an additional SECONDs assessment (C), permitting evaluation of intra-rater (A1 vs. A2) and inter-rater (A vs. C) reliability.
Results:
The SECONDs demonstrated excellent intra-rater (ICC = 0.98) and inter-rater (ICC = 0.86) reliability. Concurrent validity with the CRS-R was strong (r = 0.73, p < 0.001). Diagnostic agreement was high between A1 and B (κ = 0.75) and between both A1-A2 and A1-C (κ = 0.82). The median administration time was significantly shorter for the SECONDs (10 vs. 15 min; p < 0.001).
Conclusion:
The Argentine SECONDs is a valid, reliable, and efficient tool for the clinical assessment of DoC patients in rehabilitation settings.
