{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:50:58Z","timestamp":1791442258567,"version":"4.3.3"},"reference-count":41,"publisher":"SAGE Publications","issue":"19-20","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>\n                    This study aimed to empirically evaluate the hierarchical structure of the Coma Recovery Scale-Revised (CRS-R) rating scale categories and their alignment with the Aspen consensus criteria for determining disorders of consciousness (DoC) following a severe brain injury. CRS-R data from 262 patients with DoC following a severe brain injury were analyzed applying the partial credit Rasch Measurement Model. Rasch Analysis produced logit calibrations for each rating scale category. Twenty-eight of the 29 CRS-R rating scale categories were operationalized to the Aspen consensus criteria. We expected the hierarchical order of the calibrations to reflect Aspen consensus criteria. We also examined the association between the CRS-R Rasch person measures (indicative of performance ability) and states of consciousness as determined by the Aspen consensus criteria. Overall, the order of the 29 rating scale category calibrations reflected current literature regarding the continuum of neurobehavioral function: category 6 \u201cFunctional Object Use\u201d of the Motor item was hardest for patients to achieve; category 0 \u201cNone\u201d of the Oromotor\/Verbal item was easiest to achieve. Of the 29 rating scale categories, six were not ordered as expected. Four rating scale categories reflecting the Vegetative State (VS)\/Unresponsive Wakefulness Syndrome (UWS) had higher calibrations (reflecting greater neurobehavioral function) than the easiest Minimally Conscious State (MCS) item (category 2 \u201cFixation\u201d of the Visual item). Two rating scale categories, one reflecting MCS and one not operationalized to the Aspen consensus criteria, had higher calibrations than the easiest eMCS item (category 2 \u201cFunctional: Accurate\u201d of the Communication item). CRS-R person measures (indicating amount of neurobehavioral function) and states of consciousness, based on Aspen consensus criteria, showed a strong correlation (r\n                    <jats:sub>s<\/jats:sub>\n                    =0.86;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt;0.01). Our study provides empirical evidence for revising the diagnostic criteria for MCS to also include category 2 \u201cLocalization to Sound\u201d of the Auditory item and for Emerged from Minimally Conscious State (eMCS) to include category 4 \u201cConsistent Movement to Command\u201d of the Auditory item.\n                  <\/jats:p>","DOI":"10.1089\/neu.2022.0095","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T03:22:11Z","timestamp":1652671331000},"page":"1417-1428","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Determining the Hierarchy of Coma Recovery Scale-Revised Rating Scale Categories and Alignment with Aspen Consensus Criteria for Patients with Brain Injury: A Rasch Analysis"],"prefix":"10.1177","volume":"39","author":[{"given":"Jennifer A.","family":"Weaver","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA."},{"name":"Department of Occupational Therapy, College of Applied Health Sciences, George Washington University, Washington, DC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M.","family":"Cogan","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"TIRR Memorial Herman Rehabilitation Hospital, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piper","family":"Hansen","sequence":"additional","affiliation":[{"name":"College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph T.","family":"Giacino","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Whyte","sequence":"additional","affiliation":[{"name":"Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Bender Pape","sequence":"additional","affiliation":[{"name":"Research and Development Service, Department of Veteran Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA."},{"name":"Center for Innovation in Complex Chronic Healthcare and Research Service, Department of Veteran Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"van der Wees","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, College of Applied Health Sciences, George Washington University, Washington, DC, USA."},{"name":"Department of Rehabilitation and IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trudy","family":"Mallinson","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, College of Applied Health Sciences, George Washington University, Washington, DC, 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