Annen Jitka, Filippini Maddalena M, Bonin Estelle, Cassol Helena, Aubinet Charlène, Carrière Manon, Gosseries Olivia, Thibaut Aurore, Barra Alice, Wolff Audrey, Sanz Leandro R D, Martial Charlotte, Laureys Steven, Chatelle Camille
a GIGA Consciousness, GIGA Research Center University of Liège , Liège , Belgium.
b Centre du Cerveau² - Centre intégré pluridisciplinaire de l'étude du cerveau, de la cognition et de la conscience, University Hospital of Liège , Liège , Belgium.
Brain Inj. 2019;33(11):1409-1412. doi: 10.1080/02699052.2019.1644376. Epub 2019 Jul 18.
: To obtain a CRS-R index suitable for diagnosis of patients with disorders of consciousness (DOC) and compare it to other CRS-R based scores to evaluate its potential for clinics and research. : We evaluated the diagnostic accuracy of several CRS-R-based scores in 124 patients with DOC. ROC analysis of the CRS-R total score, the Rasch-based CRS-R score, CRS-R-MS and the CRS-R index evaluated the diagnostic accuracy for patients with the Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS). Correlations were computed between the CRS-R-MS, CRS-R index, the Rasch-based score and the CRS-R total score. : Both the CRS-R-MS and CRS-R index ranged from 0 to 100, with a cut-off of 8.315 that perfectly distinguishes between patients with UWS and MCS. The CRS-R total score and Rasch-based score did not provide a cut-off score for patients with UWS and MCS. The proposed CRS-R index correlated with the CRS-R total score, Rasch-based score and the CRS-R-MS. : The CRS-R index is reliable to diagnose patients with UWS and MCS and can be used in compliance with the CRS-R scoring guidelines. The obtained index offers the opportunity to improve the interpretation of clinical assessment and can be used in (longitudinal) research protocols. : CRS-R: Coma Recovery Scale-Revised; CRS-R-MS: Coma Recovery Scale-Revised Modified Score; DOC: Disorders of Consciousness; MCS: Minimally Conscious State; UWS: Unresponsive Wakefulness Syndrome; ROC: Receiver Operating Characteristic; AUC: Area Under the Curve; IRT: Item Response Theory.
获得适用于诊断意识障碍（DOC）患者的CRS-R指数，并将其与其他基于CRS-R的评分进行比较，以评估其在临床和研究中的潜力。
我们评估了124例DOC患者中几种基于CRS-R的评分的诊断准确性。对CRS-R总分、基于拉施模型的CRS-R评分、CRS-R-MS和CRS-R指数进行ROC分析，评估对无反应觉醒综合征（UWS）和最低意识状态（MCS）患者的诊断准确性。计算CRS-R-MS、CRS-R指数、基于拉施模型的评分与CRS-R总分之间的相关性。
CRS-R-MS和CRS-R指数范围均为0至100，临界值为8.315，可完美区分UWS和MCS患者。CRS-R总分和基于拉施模型的评分未提供UWS和MCS患者的临界值。所提出的CRS-R指数与CRS-R总分、基于拉施模型的评分和CRS-R-MS相关。
CRS-R指数对诊断UWS和MCS患者可靠，可按照CRS-R评分指南使用。所获得的指数为改善临床评估的解释提供了机会，可用于（纵向）研究方案。
CRS-R：修订版昏迷恢复量表；CRS-R-MS：修订版昏迷恢复量表修正评分；DOC：意识障碍；MCS：最低意识状态；UWS：无反应觉醒综合征；ROC：受试者工作特征；AUC：曲线下面积；IRT：项目反应理论
