Detecting early recovery of consciousness: a comparison of methods
Detecting early recovery of consciousness: a comparison of methods
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DOI：
10.1080/09602011.2017.1309322
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发表时间：
2018-11-17
影响因子：
2.7
通讯作者：
Whyte, John
中科院分区：
文献类型：
--
作者：
Day, Kristin V.;DiNapoli, Michael V.;Whyte, John
意识恢复的早期检测对预后和康复途径具有重要意义。本研究的目的是比较昏迷恢复量表修订版（CRS-R）与个体化定量行为评估（IQBA），以确定哪种方法能够更早地检测意识障碍（DoC）患者的命令遵循。回顾性分析了27例DoC患者的数据，这些患者在住院康复期间同时接受了两项评估。对于每个人，CRS-R听觉子量表项目和IQBA双命令协议的性能轨迹一起绘制，以识别更早和更一致的意识证据;分组数据进行统计分析。对于22例患者，IQBA比CRS-R更一致地记录意识，而没有患者显示相反的模式。对于20例可分析患者中的14例，IQBA提供了早期意识证据，对于2例患者，CRS-R提供了早期证据，对于4例患者，两种方法在同一天提供了初始证据。这些研究结果表明，IQBA方法可以提供更一致和更早的证据，命令以下比CRS-R上的可比项目。这种优势是由于IQBA的个性化还是收集的数据量更大，需要进一步研究。
Early detection of the return of consciousness has important implications for prognosis and rehabilitation access. The aim of this study was to compare the Coma Recovery Scale-Revised (CRS-R) with individualised quantitative behavioural assessments (IQBA) to determine which method is capable of detecting command-following earlier and more consistently in persons with disorders of consciousness (DoC). Data from 27 patients with DoC, who underwent both assessments concurrently during inpatient rehabilitation, were retrospectively analysed. For each person, performance trajectories on the CRS-R auditory subscale item and IQBA dual command protocols were graphed together to identify earlier and more consistent evidence of consciousness; grouped data were analysed statistically. For 22 patients, IQBA more consistently documented consciousness than the CRS-R, whereas no patients showed the reverse pattern. For 14 of 20 analysable patients, IQBA provided earlier evidence of consciousness, for two patients CRS-R provided earlier evidence, and for four patients both methods provided initial evidence on the same day. These findings suggest that IQBA approaches can provide more consistent and earlier evidence of command-following than the comparable item on the CRS-R. Whether this advantage is due to the individualisation of IQBA or the greater volume of data gathered requires further research.