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Titre : | Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores (2016) |
Auteurs : | Camille Chatelle ; Yelena G. Bodien ; Cecilia Carlowicz |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2016/8, 2016) |
Article en page(s) : | pp. 12951300 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Évaluation de résultat (soins) ; Rééducation et réadaptation |
Mots-clés: | Brain injuries ; Lésions encéphaliques ; Consciousness disorders ; Troubles de la conscience ; Outcome assessment (health care) |
Résumé : |
Objective To determine the frequency with which specific Coma Recovery Scale-Revised (CRS-R) subscale scores co-occur as a means of providing clinicians and researchers with an empirical method of assessing CRS-R data quality. Design We retrospectively analyzed CRS-R subscale scores in hospital inpatients diagnosed with disorders of consciousness (DOCs) to identify impossible and improbable subscore combinations as a means of detecting inaccurate and unusual scores. Impossible subscore combinations were based on violations of CRS-R scoring guidelines. To determine improbable subscore combinations, we relied on the Mahalanobis distance, which detects outliers within a distribution of scores. Subscore pairs that were not observed at all in the database (ie, frequency of occurrence=0%) were also considered improbable. Setting Specialized DOC program and university hospital. Participants Patients diagnosed with DOCs (N=1190; coma: n=76, vegetative state: n=464, minimally conscious state: n=586, emerged from minimally conscious state: n=64; 794 men; mean age, 43+20y; traumatic etiology: n=747; time postinjury, 162+568d). Interventions Not applicable. Main Outcome Measure Impossible and improbable CRS-R subscore combinations. Results Of the 1190 CRS-R profiles analyzed, 4.7% were excluded because they met scoring criteria for impossible co-occurrence. Among the 1137 remaining profiles, 12.2% (41/336) of possible subscore combinations were classified as improbable. Conclusions Clinicians and researchers should take steps to ensure the accuracy of CRS-R scores. To minimize the risk of diagnostic error and erroneous research findings, we have identified 9 impossible and 36 improbable CRS-R subscore combinations. The presence of any one of these subscore combinations should trigger additional data quality review. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999316001404 |