Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS