• Caroline Schnakers, Steve Majerus, Joseph Giacino, Audrey Vanhaudenhuyse, Marie-Aurelie Bruno, Melanie Boly, Gustave Moonen, Pierre Damas, Bernard Lambermont, Maurice Lamy, Francois Damas, Manfredi Ventura, and Steven Laureys.
• Coma Science Group, Cyclotron Research Centre, University of Liège, Liège, Belgium. c.schnakers@student.ulg.ac.be
• Brain Inj. 2008 Sep 1;22(10):786-92.

Primary ObjectiveThe aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM).Research DesignMulti-centric prospective study.Method And ProceduresTo test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement.Main Outcomes And ResultsGood concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM.ConclusionThe results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff.

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