Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores.
Arch Phys Med Rehabil
; 97(8): 1295-1300.e4, 2016 08.
Article
em En
| MEDLINE
| ID: mdl-26944708
ABSTRACT
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 OUTCOMEMEASURE:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
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Índices de Gravidade do Trauma
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Modalidades de Fisioterapia
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Transtornos da Consciência
Tipo de estudo:
Diagnostic_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2016
Tipo de documento:
Article