The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility

Arch Phys Med Rehabil. 2004 Dec;85(12):2020-9. doi: 10.1016/j.apmr.2004.02.033.


Objective: To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R).

Design: Analysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy.

Setting: Acute inpatient brain injury rehabilitation hospital.

Participants: Convenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS).

Interventions: Not applicable.

Main outcome measures: The CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS).

Results: Interrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS.

Conclusions: The CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Injuries / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / physiopathology*
  • Psychometrics
  • Recovery of Function / physiology*
  • Reproducibility of Results
  • Sampling Studies
  • Trauma Severity Indices*
  • United States