A French validation study of the Coma Recovery Scale-Revised (CRS-R)

Brain Inj. 2008 Sep;22(10):786-92. doi: 10.1080/02699050802403557.


Primary objective: The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM).

Research design: Multi-centric prospective study.

Method and procedures: To test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement.

Main outcomes and results: Good concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM.

Conclusion: The results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Damage, Chronic / diagnosis
  • Brain Injuries / diagnosis*
  • Coma / diagnosis
  • Consciousness / physiology
  • Diagnosis, Differential
  • Female
  • Humans
  • Language
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Observer Variation
  • Persistent Vegetative State / diagnosis*
  • Prognosis
  • Prospective Studies
  • Recovery of Function / physiology
  • Sensitivity and Specificity
  • Trauma Severity Indices*