Personalized objects can optimize the diagnosis of EMCS in the assessment of functional object use in the CRS-R: a double blind, randomized clinical trial.
Personalized objects can optimize the diagnosis of EMCS in the assessment of functional object use in the CRS-R: a double blind, randomized clinical trial.
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个性化对象可以在 CRS-R 中功能对象使用评估中优化 EMCS 诊断：双盲、随机临床试验
DOI：
10.1186/s12883-018-1040-5
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发表时间：
2018-04-12
期刊：
影响因子：
2.6
通讯作者：
Di H
中科院分区：
文献类型：
--
作者：
Sun Y;Wang J;Heine L;Huang W;Wang J;Hu N;Hu X;Fang X;Huang S;Laureys S;Di H
行为评估已成为诊断意识障碍(DOC)患者的金标准。昏迷恢复量表(CRS-R)运动功能子量表中的“功能物体使用”项是区分最低意识状态(MCS)和从MCS中苏醒(EMCS)的关键项目。然而，以往的研究表明，某些特定的刺激，特别是一些与自身相关的刺激，会影响DOC患者的行为评定量表的得分。因此，我们试图通过比较患者最喜欢的对象和其他常见对象在MCS患者中的使用情况，来了解个性化对象在评估功能对象使用方面是否可以提高EMCS的诊断水平。21名被诊断为MCS的昏迷后患者被前瞻性纳入。通过使用以随机顺序呈现的个性化对象(例如，香烟、纸张)和非个性化对象来评估项目“功能对象使用”。其余的评估按照CRS-R的标准方案进行。通过McNemar检验分析两类客体的功能用法差异。在CRS-R中，使用个性化对象的功能性对象的发生率显著高于非个性化对象。在21名MCS研究患者中，有5名患者使用非个性化对象进行评估，重新诊断为具有个性化对象的EMCS(χ2=0.5，DF = 1，p <； 0.05)。在评估DOC患者的功能对象使用时，与非个性化对象相比，这里使用的个性化对象似乎更能有效地引起患者的反应。临床试验.gov：nct02988206；注册日期：2016年12月12日。本文的在线版本(10.1186/s12883-018-1040-5)包含补充材料，授权用户可以获得。
Behavioral assessment has been acted as the gold standard for the diagnosis of disorders of consciousness (DOC) patients. The item “Functional Object Use” in the motor function sub-scale in the Coma Recovery Scale-Revised (CRS-R) is a key item in differentiating between minimally conscious state (MCS) and emergence from MCS (EMCS). However, previous studies suggested that certain specific stimuli, especially something self-relevant can affect DOC patients’ scores of behavioral assessment scale. So, we attempted to find out if personalized objects can improve the diagnosis of EMCS in the assessment of Functional Object Use by comparing the use of patients’ favorite objects and other common objects in MCS patients. Twenty-one post-comatose patients diagnosed as MCS were prospectively included. The item “Functional Object Use” was assessed by using personalized objects (e.g., cigarette, paper) and non-personalized objects, which were presented in a random order. The rest assessments were performed following the standard protocol of the CRS-R. The differences between functional uses of the two types of objects were analyzed by the McNemar test. The incidence of Functional Object Use was significantly higher using personalized objects than non-personalized objects in the CRS-R. Five out of the 21 MCS studied patients, who were assessed with non-personalized objects, were re-diagnosed as EMCS with personalized objects (χ2 = 5, df = 1, p < 0.05). Personalized objects employed here seem to be more effective to elicit patients’ responses as compared to non-personalized objects during the assessment of Functional Object Use in DOC patients. Clinical Trials.gov: NCT02988206; Date of registration: 2016/12/12. The online version of this article (10.1186/s12883-018-1040-5) contains supplementary material, which is available to authorized users.
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影响因子：
48
作者：
Di Perri, Carol;Bahri, Mohamed Ali;Laureys, Steven
通讯作者：
Laureys, Steven
影响因子：
2.6
作者：
Di H;Nie Y;Hu X;Tong Y;Heine L;Wannez S;Huang W;Yu D;He M;Thibaut A;Schnakers C;Laureys S
通讯作者：
Laureys S
影响因子：
--
作者：
Perrin, F;Schnakers, C;Laureys, S
通讯作者：
Laureys, S
DOI：
10.1196/annals.1417.018
发表时间：
2008-01-01
期刊：
MOLECULAR AND BIOPHYSICAL MECHANISMS OF AROUSAL, ALERTNESS, AND ATTENTION
影响因子：
--
作者：
Owen, Adrian M.;Coleman, Martin R.
通讯作者：
Coleman, Martin R.
DOI：
10.1016/j.apmr.2004.02.033
发表时间：
2004-12-01
影响因子：
4.3
作者：
Giacino, JT;Kalmar, K;Whyte, J
通讯作者：
Whyte, J