On the afternoon of October 24, Zijinshan News reported on the launch meeting of our institute’s multi-center study on the analysis of reliability and validity. The following is Zijinshan News’ coverage of our institute:

The long-term treatment costs and the complex caregiving burden associated with patients suffering from disorders of consciousness impose a heavy economic and psychological strain on their families. Accurately assessing changes in a patient’s level of consciousness—from a vegetative state to recovery—can inform more precise clinical interventions, but this requires reliable and valid measurement tools. Today, the multi-center study “Reliability and Validity Analysis of the China–Nanjing Consciousness Recovery Scale (CNCRS),” led by Nanjing Zijin Hospital, was launched in Nanjing. Experts and scholars from across the country specializing in disorders of consciousness are collaborating to refine this consciousness‑recovery diagnostic and therapeutic standard initiated in Nanjing, thereby filling a critical gap in this field in China and advancing the development of rehabilitation medicine in the country.

The transition of a patient from a vegetative state to wakefulness is a prolonged process. In the absence of communicative ability, how to more accurately characterize the patient’s level of consciousness and implement tiered management has long been a challenge for clinicians and researchers in related fields, as well as a central issue of great interest in critical care and rehabilitation medicine. Precise assessment of disorders of consciousness in patients with brain injury using neurobehavioral scales has been designated as a Class I recommendation supported by Level A evidence in guidelines across multiple countries. For a long time, China lacked such tools, with clinical scales in use being developed in Europe and North America. As the only tertiary‑level rehabilitation hospital in Nanjing, Nanjing Zijin Hospital has taken the lead in developing the “Nanjing Scale for Persistent Vegetative State,” tailored to China’s specific context. This “Nanjing Standard” not only fills a critical gap in the field within China but also helps align domestic diagnostic and outcome‑assessment criteria for patients in a vegetative state.

Following nationwide expert review and revision, the latest version of the “China Nanjing Scale for Recovery of Consciousness” has been widely implemented in clinical practice. “The newly revised scale has removed the language subscale and added subscales for feeding responses and emotional responses,” explained Gao Zhiqiang, Executive Vice President of Nanjing Zijin Hospital. “Among patients with disorders of consciousness, many have undergone tracheostomies and are unable to speak, while others have damage to the language centers and cannot produce speech. Consequently, the language subscale significantly compromised the scale’s reliability. By contrast, the emotional‑response and feeding‑response subscales have enriched the assessment.” According to reports, the new scale has already been used to evaluate more than 2,000 patients, with both reliability and validity markedly improved compared with the previous version. “With more accurate diagnoses, clinicians now have access to more precise treatment strategies. As a result, the average length of hospital stay has decreased compared with last year, while the number of hospitalized patients has increased by approximately 20%—a trend that the scale’s clinical application has helped to drive significantly.”

To thoroughly investigate whether the revised scale is applicable to patients of different genders and age groups and whether it can encompass the entire continuum of consciousness recovery—from coma to full wakefulness—the “Multicenter Study on the Reliability and Validity of the Chinese Nanjing Coma Recovery Scale (CNCRS)” was launched. Leading domestic hospitals with strong research capabilities and the capacity to ensure reliable assessments were selected as sub‑centers, and through comparative analysis of multicenter data, the scale’s reliability and validity were ultimately evaluated.

Industry experts believe that the launch of this research could pave the way for the “Nanjing Standard” to be widely adopted across domestic academic disciplines. Professor Bi Sheng, Chairman of the Rehabilitation Medicine Professional Committee of the China Association of Non‑Public Medical Institutions, stated that once revised and refined, the new scale—after rigorous validation—will not only be suitable for nationwide implementation but may even gain international recognition. Professor Li Jian’an, Honorary Director of the Rehabilitation Medicine Center at the First Affiliated Hospital of Nanjing Medical University, noted that, as a reliable measuring tool, the new scale assesses both the severity of illness and the effectiveness of therapeutic recovery, serving as an important criterion for selecting treatment strategies and determining insurance reimbursement thresholds. “Treatment efficacy is a key factor in health‑insurance regulation; next year, Nanjing will initiate reforms to adopt a function‑oriented reimbursement model for rehabilitation services. I am confident that this scale will become an integral component of that reform framework.”

Nanjing Daily/Zijinshan News Reporter Wang Jieyu (Original article link: http://m.zjsnews.cn/news/7189906954410240765)