Simplified evaluation of CONsciousness disorders (SECONDs) in individuals with severe brain injury: A validation study
Charlène Aubinet, Helena Cassol, Olivier Bodart, Leandro R D Sanz, Sarah Wannez, Charlotte Martial, Aurore Thibaut, Géraldine Martens, Manon Carrière, Olivia Gosseries, Steven Laureys, Camille Chatelle, Charlène Aubinet, Helena Cassol, Olivier Bodart, Leandro R D Sanz, Sarah Wannez, Charlotte Martial, Aurore Thibaut, Géraldine Martens, Manon Carrière, Olivia Gosseries, Steven Laureys, Camille Chatelle
Abstract
Background: The Coma Recovery Scale-Revised (CRS-R) is the gold standard to assess severely brain-injured patients with prolonged disorders of consciousness (DoC). However, the amount of time needed to complete this examination may limit its use in clinical settings.
Objective: We aimed to validate a new faster tool to assess consciousness in individuals with DoC.
Methods: This prospective validation study introduces the Simplified Evaluation of CONsciousness Disorders (SECONDs), a tool composed of 8 items: arousal, localization to pain, visual fixation, visual pursuit, oriented behaviors, command-following, and communication (both intentional and functional). A total of 57 individuals with DoC were assessed on 2 consecutive days by 3 blinded examiners: one CRS-R and one SECONDs were performed on 1 day, whereas 2 SECONDs were performed on the other day. A Mann-Whitney U test was used to compare the duration of administration of the SECONDs versus the CRS-R, and weighted Fleiss' kappa coefficients were used to assess inter-/intra-rater reliability as well as concurrent validity.
Results: In the 57 participants, the SECONDs was about 2.5 times faster to administer than the CRS-R. The comparison of the CRS-R versus the SECONDs on the same day or the best of the 3 SECONDs led to "substantial" or "almost perfect" agreement (kappa coefficients ranging from 0.78 to 0.85). Intra-/inter-rater reliability also showed almost perfect agreement (kappa coefficients from 0.85 to 0.91 and 0.82 to 0.85, respectively).
Conclusions: The SECONDs appears to be a fast, reliable and easy-to-use scale to diagnose DoC and may be a good alternative to other scales in clinical settings where time constraints preclude a more thorough assessment.
Keywords: Coma; Disorders of consciousness; Rehabilitation; Trauma.
Copyright © 2020 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.
Source: PubMed