ArticleBMC neurology2020
The misdiagnosis of prolonged disorders of consciousness by a clinical consensus compared with repeated coma-recovery scale-revised assessment.
Article in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04139239 (Diagnostic Accuracy of the Vegetative and Minimally Conscious State), which is not on this map. Cited by 64 papers, 4 of them syntheses that pooled it.
What it found
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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.
Diagnostic Accuracy of the Vegetative and Minimally Conscious State: Clinical Consensus Versus Standardized Neurobehavioral Assessment
Who cites it
64 citing papers in PubMed, 4 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- A methodological guideline for consciousness assessment via neural electrophysiological activity.Military Medical Research · 2025Guideline
- Best Evidence Summary for the Improvement and Management of Disorders of Consciousness in Patients With Severe Brain Injury.Brain and behavior · 2025Pooled it
- The Neurological Rehabilitation of Adults With Coma and Disorders of Consciousness.Deutsches Arzteblatt international · 2023Guideline
- Mapping fMRI research in disorders of consciousness: a bibliometric study.Frontiers in neurologyPooled it
- Long-term HRV metrics may assist in differentiating between prolonged disorders of consciousness and emergence from minimally conscious state : a cross-sectional study.Acta neurologica Belgica · 2026Article
- An explainable multimodal machine learning model for diagnosing disorders of consciousness: evidence from a large multicenter Chinese cohort.Journal of translational medicine · 2026Observational
- Exploring sex hormones as potential prognostic biomarkers in prolonged disorders of consciousness: a sex-specific retrospective study.Frontiers in neurology · 2026Article
- Cortical processing modulation in DOC by preferred music-coupled 40 Hz binaural stimulation: an exploratory EEG-fNIRS study.Frontiers in psychology · 2026Article
- A thalamic perspective of (un)consciousness in pharmacological and pathological states in humans.Brain communications · 2026Article
- Prospective validation protocol for artificial intelligence-assisted standardization of Coma Recovery Scale-Revised scores using electroencephalography and clinical data in disorders of consciousness.Frontiers in medicine · 2026Article
- Auditory paradigm-dependent EEG feature screening and representation for distinguishing consciousness states in male patients with disorders of consciousness.Frontiers in neurology · 2026Article
- Effects of motor imagery brain-computer interface task on quantitative EEG features in patients with prolonged disorders of consciousness.Frontiers in neuroscience · 2026Article
- Temporal network instability and low-frequency overconnectivity underlie disorders of consciousness in severe brain injury.Scientific reports · 2025Article
- Disrupted hierarchical organization in disorders of consciousness revealed by fluctuation-dissipation deviations.bioRxiv : the preprint server for biology · 2025Article
- Autonomic heart rate variability trends predict outcome in disorders of consciousness.Scientific reports · 2025Article
- Blink reflex as a prognostic indicator for patients with prolonged disorders of consciousness: a prospective case-control study.BMJ open · 2025Article
- Prognostic utility of somatosensory evoked potentials in supratentorial hemorrhage-induced prolonged disorders of consciousness.European journal of medical research · 2025Article
- Predictors of Recovering Full Consciousness: Results From a Prospective Multisite Italian Study.European journal of neurology · 2025Observational
- Eye tracking to support assessment of patients with prolonged disorder of consciousness - a case series.Journal of rehabilitation medicine · 2025Observational
- The development and face validity of the music therapy sensory instrument for cognition, consciousness, and awareness (MuSICCA).Frontiers in psychology · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPrevious studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high rates of misdiagnosis by clinical consensus. The aim of this study was to investigate the proportion of misdiagnosis by clinical consensus compared to repeated behavior-scale assessments in patients with prolonged disorders of consciousness (DOC).
methodsPatients with prolonged DOC during hospitalization were screened by clinicians, and the clinicians formed a clinical-consensus diagnosis. Trained professionals used the CRS-R to evaluate the consciousness levels of the enrolled patients repeatedly (≥5 times) within a week. Based on the repeated evaluation results, the enrolled patients with prolonged DOC were divided into unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS), and emergence from MCS (EMCS). Finally, the relationship between the results of the CRS-R and the clinical consensus were analyzed.
resultsIn this study, 137 patients with a clinical-consensus diagnosis of prolonged DOC were enrolled. It was found that 24.7% of patients with clinical UWS were actually in MCS after a single CRS-R behavior evaluation, while the repeated CRS-R evaluation results showed that the proportion of misdiagnosis of MCS was 38.2%. A total of 16.7% of EMCS patients were misdiagnosed with clinical MCS, and 1.1% of EMCS patients were misdiagnosed with clinical UWS.
conclusionsThe rate of the misdiagnosis by clinical consensus is still relatively high. Therefore, clinicians should be aware of the importance of the bedside CRS-R behavior assessment and should apply the CRS-R tool in daily procedures.
trial registrationClinicalTrials.gov ID: NCT04139239 ; Registered 24 October 2019 - Retrospectively registered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.