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

Research design: Analysis of inter-rater reliability and concurrent validity. Objective: To determine measurement properties of a Spanish version of The Coma Recovery Scale-Revised (CRS-R). Methods and procedures: A sample of 35 in-patients with severe acquired brain injury. To test concurrent validity of the translated scale, the Glasgow Coma Scale (GSC) and Disability Rating Scale (DRS) were also administered. Two experts in the field were recruited to assess inter-rater agreement. Results: Inter-rater reliability was good for total CRS-R scores (Cronbach alpha = 0.973, p = 0.001). Sub-scale analysis showed moderate-to-high inter-rater agreement. Total CRS-R scores correlated significantly (p<0.05) with total GCS (r = 0.74) and DRS (r = 0.54) scores, indicating acceptable concurrent validity. Conclusions: The Spanish version of CRS-R can be administered reliably by trained and experienced examiners. CRS-R appears capable of differentiating patients in Emergence from Minimally Conscious State (EMCS) or in Minimally Conscious State (MCS) from those in a Vegetative State (VS).