Reliability and validation of the Japanese version of the coma recovery scale-revised (CRS-R)

Primary objectiveThis study aimed to verify the reliability and validity of the Japanese version of the Coma Recovery Scale-Revised (CRS-R).MethodsSubjects included 59 patients with disorders of consciousness (DOC) due to acquired brain injury. To validate test-retest reliability, Evaluator A assessed the CRS-R twice on the same day (A1, A2). To examine inter-rater reliability, Evaluators A (A2) and B (B) assessed the CRS-R without a time interval. To test concurrent validity, Evaluator A (A1) assessed the CRS-R, Japan Coma Scale (JCS), and the Glasgow Coma Scale (GCS) consecutively. To validate diagnostic accuracy, we evaluated the degree of agreement between A1 and A2 and between A2 and B in their diagnosis of DOC by CRS-R.ResultsThe test-retest (rho = 0.92) and inter- (rho = 0.98) reliability of CRS-R were excellent" and Concurrent validity of CRS-R with JCS (rho = -0.82) and GCS (rho = 0.92) were high. Results of DOC diagnosis were consistent for 48/59 cases (kappa = 0.82) for A1 and A2 and for 54/59 cases (kappa = 0.92) for A2 and B.ConlcusionThe Japanese version of the CRS-R may be as reliable and valid as the original English and other language versions.