Interrater Reliability of the Coma Recovery Scale

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Abstract
Objective: To assess interrater reliability (IRR) of the Coma Recovery Scale (CRS), a tool to evaluate recovery from severe brain injury and efficacy of interventions in minimally responsive patients. Design: Simultaneous CRS assessments of persons with brain injury were performed by 3 rehabilitation professionals of differing disciplines. CRS scores were independently assigned with 1 rater administering the CRS and the other 2 observing. Setting: Acute inpatient brain injury rehabilitation and long–term care units. Patients: A convenience sample of 18 persons with severe brain injuries at Rancho levels 1 to 4. Results: Spearman's correlation coefficients for CRS subscores were very strong among the 3 raters (r=60 to .96, all P <.01). Kappa statistic was calculated for the overall CRS at 0.69, indicating “substantial agreement.” Conclusion: We conclude that the IRR of the CRS is adequate for use with individuals at Rancho Levels 1 to 4. Further research should examine IRR in the upper range of the scale (ie, with higher functioning patients) and in more acutely injured patients

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