Reliability and diagnostic characteristics of the JFK coma recovery scale-revised: exploring the influence of rater's level of experience

J Head Trauma Rehabil. Sep-Oct 2010;25(5):349-56. doi: 10.1097/HTR.0b013e3181cec841.


Objective: To confirm the reliability and diagnostic validity of the JFK Coma Recovery Scale-Revised (CRS-R) across raters with varying levels of experience.

Methods: Thirty-one patients with disorders of consciousness were recruited from 6 Norwegian hospitals.

Main outcome measures: CRS-R and the Disability Rating Scale.

Results: Reliability measures were good for the CRS-R total scores and moderate to good for its subscales. Diagnostic agreement among examiners was good. Raters' experience with the CRS-R favorably influenced reliability. Sensitivity and specificity analyses demonstrated better detection of patients in minimally conscious state on the CRS-R relative to the Disability Rating Scale.

Conclusions: The CRS-R is a reliable tool for diagnosing vegetative state and minimally conscious state. Raters' level of experience influences the reliability of the CRS-R scores.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Coma / complications*
  • Coma / rehabilitation
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Observer Variation
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / etiology*
  • Reproducibility of Results
  • Young Adult