SynthesisJournal of neurotrauma2019
The Relationship of the FOUR Score to Patient Outcome: A Systematic Review.
Synthesis in Journal of neurotrauma, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Predictive Validity of the Full Outline of UnResponsiveness Score Compared to the Glasgow Coma Scale in the Intensive Care Unit: A Systematic Review.Neurocritical care · 2025Pooled it
- Comparison of Glasgow Coma Scale and Full Outline of UnResponsiveness score for prediction of in-hospital mortality in traumatic brain injury patients: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Pooled it
- Predictive Accuracy of Glasgow Coma Scale and Pupillary Data on Presence of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
- Quantitatively controlled and measured-traumatic brain injury impairs adult neurogenesis and alters neuropathological signatures in mice.Theranostics · 2026Article
- Comparing the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale (GCS) for predicting outcomes in traumatic brain injury: a comparative study.Journal of trauma and injury · 2025Article
- Effects of educational intervention on knowledge of Full Outline of Un-Responsiveness score among health workers in uganda: a quasi -experimental pilot study.BMC medical education · 2025Article
- Article
- Development of a nomogram for predicting the outcome in patients with prolonged disorders of consciousness based on the multimodal evaluative information.BMC neurology · 2025Article
- Complex auditory regularity processing across levels of consciousness in coma: Stage 1 Registered Report.Brain communications · 2025Article
- The Glasgow Coma Scale and Full Outline of Unresponsiveness score evaluation to predict patient outcomes with neurological illnesses in intensive care units in West Bank: a prospective cross-sectional study.Acute and critical care · 2024Article
- Comparison of the Prognostic Accuracy of Full Outline of Unresponsiveness (FOUR) Score with Glasgow Coma Scale (GCS) Score among Patients with Traumatic Brain Injury in a Tertiary Care Center.Asian journal of neurosurgery · 2024Article
- Early Shared Decision-Making for Older Adults with Traumatic Brain Injury: Using Time-Limited Trials and Understanding Their Limitations.Neurocritical care · 2023Article
- Comparison of admission GCS score to admission GCS-P and FOUR scores for prediction of outcomes among patients with traumatic brain injury in the intensive care unit in India.Acute and critical care · 2023Article
- Article
- Behavioral Assessment of Patients with Disorders of Consciousness.Seminars in neurology · 2022Review
- A Comparison of Full Outline of UnResponsiveness Score with Glasgow Coma Scale Score in Predicting Outcomes among Patients with Altered Mental Status Admitted to the Critical Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- A prediction model of clinical outcomes in prolonged disorders of consciousness: A prospective cohort study.Frontiers in neuroscience · 2022Article
- Protocol to assess performance of crisis standards of care guidelines for clinical triage.STAR protocols · 2021Article
- Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies.Nature reviews. Neurology · 2021Review
- Resting-State NIRS-EEG in Unresponsive Patients with Acute Brain Injury: A Proof-of-Concept Study.Neurocritical care · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Full Outline of UnResponsiveness (FOUR) score assessment of consciousness replaces the Glasgow Coma Scale (GCS) verbal component with assessment of brainstem reflexes. A comprehensive overview studying the relationship between a patient's FOUR score and outcome is lacking. We aim to systematically review published literature reporting the relationship of FOUR score to outcome in adult patients with impaired consciousness. We systematically searched for records of relevant studies: CENTRAL, MEDLINE, EMBASE, Scopus, Web of Science, ClinicalTrials.gov, and OpenGrey. Prospective, observational studies of patients with impaired consciousness were included where consciousness was assessed using FOUR score, and where the outcome in mortality or validated functional outcome scores was reported. Consensus-based screening and quality appraisal were performed. Outcome prognostication was synthesized narratively. Forty records (37 studies) were identified, with overall low (
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