On the afternoon of October 26, the Health Client of Xinhua Daily reported on the kickoff meeting for our hospital’s multi-center study on the reliability and validity analysis. Below is the report by the Xinhua Daily Health Client:

Disorders of consciousness refer to a state of wakefulness without awareness that arises following severe brain injury caused by various etiologies. Accurately measuring and assessing a patient’s level of consciousness is critical for diagnosis, treatment, and outcome evaluation. On October 24, the kickoff meeting for the multi-center study on the reliability and validity analysis of the Chinese-Nanjing Coma Recovery Scale (CNCRS) was held in Nanjing. The study aims to lay a solid foundation for the further development and dissemination of a domestically developed assessment scale for disorders of consciousness in China, through multi-center clinical case collection, statistical analysis, and the preparation of research publications.

The reporter learned that developed countries—particularly those in Europe, the United States, Japan, and South Korea—have largely established their own indigenous assessment scales, whereas China once lacked such tools. As the only tertiary‑level rehabilitation hospital currently in Nanjing, Nanjing Zijin Hospital is among the earliest medical institutions in China to engage in cerebral resuscitation and the treatment of patients in a vegetative state. Since pioneering the formulation of the “Vegetative State” diagnostic and therapeutic standards for Nanjing, China, in 1996, the hospital has initiated six subsequent revisions, helping to standardize diagnostic criteria and outcome‑assessment protocols for vegetative‑state patients across the country. As the nation’s sole continuous‑state‑of‑consciousness scoring system, this standard not only fills a critical gap in the field but also enables clinicians to deliver more precise care to patients with disorders of consciousness.

Over the past year and more since the 2023 revision of the “Nanjing Consciousness Recovery Scale of China” was implemented in clinical practice, how has it performed? “After one year, based on clinical statistical analyses, we have found that both its reliability and validity surpass those of the previous version. We hope that this multi-center study will further validate its reliability and validity,” said Gao Zhiqiang, Executive Vice President of Nanjing Zijin Hospital. He added that the average length of hospital stay has been significantly reduced compared with last year, indicating that the scale’s clinical application has substantially advanced routine clinical workflows.

The assessment and rehabilitation of patients with consciousness disorders are key issues that have drawn significant attention in both critical care medicine and rehabilitation medicine. Bi Sheng, Chairman of the Rehabilitation Medicine Professional Committee of the China Association of Non-public Medical Institutions, stated that the newly revised scoring scales are more precise and user-friendly. Compared with internationally prevalent standards from countries such as the United Kingdom and the United States, the “Nanjing Standard” is better suited to the Chinese context and has been further refined and adapted to reflect current clinical needs.

“The new scale has been revised to address the shortcomings of previous versions; it should not only be widely adopted in China but could also serve as a platform for China to voice its perspectives on the international stage, carrying significant implications and promising prospects for development,” said Li Jian’an, Honorary Director of the Rehabilitation Medicine Center at Jiangsu Provincial People’s Hospital (the First Affiliated Hospital of Nanjing Medical University and Jiangsu Provincial Maternal and Child Health Care Institute).

The newly revised scale has removed the language‑response subscale and added subscales for feeding response and emotional response. “We assess patients with disorders of consciousness; many have a tracheostomy and cannot speak, while others are unable to communicate because their language centers have been damaged. Consequently, the language subscale compromised the validity of the scale’s scoring. By incorporating subscales for feeding and emotional responses, we have enriched the instrument, which I believe is entirely reasonable,” explained Li Jian’an.

“If a scale has not been thoroughly discussed, its scientific validity cannot be established. That’s why we launched this research initiative—to identify any potential issues and to build national consensus. Only when everyone agrees that the scale is viable will it have a better chance of being adopted nationwide,” said Li Jian’an. “The convening of this symposium will further promote our country’s own assessment tool, better serve Chinese patients, and contribute to the advancement of rehabilitation medicine in China.”

(Original article link: https://m.peopledailyhealth.com/articleDetailShare?articleId=14a2653b91d142149096dde5fb6b1f0d&_t=1729911818296)