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We compared the prognostic accuracy of a novel Consciousness Domain Index (CDI) with that of clinical diagnosis and CRS-R total score, for recovery of full consciousness at 6-, 12-, and 24-months post-injury. The CDI was obtained by a combination of the six CRS-R subscales via an unsupervised machine learning technique. We retrospectively analyzed data on 143 patients with pDoC (75 in Minimally Conscious State; 102 males; median age = 53 years; IQR = 35; time post-injury = 1\u20133 months) due to different etiologies enrolled in an International Brain Injury Association Disorders of Consciousness Special Interest Group (IBIA DoC-SIG) multicenter longitudinal study. Univariate and multivariate analyses were utilized to assess the association between outcomes and the CDI, compared to clinical diagnosis and CRS-R. The CDI, the clinical diagnosis, and the CRS-R total score were significantly associated with a good outcome at 6, 12 and 24 months. The CDI showed the highest univariate prediction accuracy and sensitivity, and regression models including the CDI provided the highest values of explained variance. A combined scoring system of the CRS-R subscales by unsupervised machine learning may improve clinical ability to predict recovery of consciousness in patients with pDoC.<\/jats:p>","DOI":"10.3390\/brainsci13010051","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T08:38:19Z","timestamp":1672216699000},"page":"51","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Predicting Long-Term Recovery of Consciousness in Prolonged Disorders of Consciousness Based on Coma Recovery Scale-Revised Subscores: Validation of a Machine Learning-Based Prognostic Index"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3834-6392","authenticated-orcid":false,"given":"Alfonso","family":"Magliacano","sequence":"first","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Firenze, Italy"},{"name":"Polo Specialistico Riabilitativo, Fondazione Don Carlo Gnocchi, 83054 Sant\u2019Angelo dei Lombardi,  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6067-474X","authenticated-orcid":false,"given":"Piergiuseppe","family":"Liuzzi","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Firenze, Italy"},{"name":"Scuola Superiore Sant\u2019Anna, Istituto di BioRobotica, 56025 Pontedera, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2516-0540","authenticated-orcid":false,"given":"Rita","family":"Formisano","sequence":"additional","affiliation":[{"name":"Fondazione Santa Lucia IRCCS, 00179 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-8564","authenticated-orcid":false,"given":"Antonello","family":"Grippo","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymios","family":"Angelakis","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, University of Athens Medical School, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5991-1747","authenticated-orcid":false,"given":"Aurore","family":"Thibaut","sequence":"additional","affiliation":[{"name":"Coma Science Group, GIGA Consciousness-University and University Hospital of Li\u00e8ge-Li\u00e8ge-Belgium, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9011-7496","authenticated-orcid":false,"given":"Olivia","family":"Gosseries","sequence":"additional","affiliation":[{"name":"Coma Science Group, GIGA Consciousness-University and University Hospital of Li\u00e8ge-Li\u00e8ge-Belgium, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3288-5275","authenticated-orcid":false,"given":"Gianfranco","family":"Lamberti","sequence":"additional","affiliation":[{"name":"Neurorehabilitation and Vegetative State Unit E. 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