In early summer, Shenzhen is suffused with the fragrance of scholarship;

With hearts united, physicians work together to advance recovery.

On the evening of May 8, 2026, a summary meeting on the interim findings of the multi-center study of the China Nanjing Consciousness Recovery Scale (CNCRS)—initiated and organized by Nanjing Zijin Hospital—was successfully held in Shenzhen. The meeting brought together leading experts and core researchers in the field of consciousness disorders from more than ten renowned medical institutions across China, including Beijing Tiantan Hospital, Beijing Chaoyang Hospital, Shanghai Huashan Hospital, Tianjin Medical University General Hospital, Zhejiang Provincial People’s Hospital, Nanchang University Affiliated Rehabilitation Hospital, Xiangya Bo’ai Rehabilitation Hospital, Shanxi Bethune Hospital, the First Affiliated Hospital of Guangxi Medical University, and the Second Hospital of Hebei Medical University. Participants convened to comprehensively review the year-long progress of the multi-center study, engage in in-depth discussions on the data outcomes, and jointly map out strategic pathways for translating research findings into clinical applications and scaling up their implementation. This milestone marks a critical new phase in the development and application of China’s independently developed, original consciousness assessment system—one that transitions from empirical accumulation to standard-setting.

Outstanding Achievements: Large-Scale Empirical Studies Lay the Evidence-Based Foundation for the “Chinese Standard”

The China Nanjing Consciousness Recovery Scale (CNCRS) is a chronic disorders of consciousness assessment tool independently developed by Nanjing Zijin Hospital, drawing on decades of clinical practice and focusing on the disease characteristics and rehabilitation trajectories of Chinese patients. Its creation has filled a critical gap in China, where no localized, precision‑based assessment standards previously existed in this field. The key findings presented at this summary meeting indicate that the CNCRS multicenter study, which began enrolling patients simultaneously across all participating centers nationwide in March 2025 and concluded in March 2026, successfully completed standardized clinical data collection for a total of 1,540 high‑quality cases, thereby fully achieving its pre‑defined research objectives.

In her opening address, Ge Jiangping, President of Nanjing Zijin Hospital, pointed out that the 1,540 cases represented not only the fruit of close collaboration among all participating institutions but also the most robust evidence‑based foundation in CNCRS’s transition from a hospital‑specific standard to a national consensus‑driven industry benchmark. She emphasized that the study adhered rigorously to international multicenter clinical trial guidelines, undergoing standardized online training, interim oversight, and the publication of the “Revised Chinese Nanjing Scale for Consciousness Recovery and the Multicenter Study Expert Consensus,” thereby ensuring the standardization and homogeneity of data collection. This has made it possible to validate the scale’s reliability and validity in large samples, while also providing a core tool to support the standardization and规范化 of diagnosis and treatment for disorders of consciousness in China.

Data Pivot: Multidimensional Reporting Unveils Research Depth and Organizational Effectiveness

During the results‑presentation session, Director Liu Yafeng and Director Wang Changbao of Nanjing Zijin Hospital each provided a comprehensive overview of the data from their respective sub‑centers. The presentations not only highlighted each center’s contributions in terms of patient enrollment—some centers even surpassed their targets—but also offered an in‑depth analysis across multiple dimensions, including the overall demographic characteristics of the study cohort, the distribution of etiologies, baseline levels of consciousness, the completeness of assessment time points, and key quality‑control indicators.

For example, data analysis has preliminarily revealed the patterns of change in CNCRS scores among patients with disorders of consciousness resulting from different etiologies, such as traumatic brain injury, stroke, and hypoxic‑ischemic encephalopathy. Meanwhile, the quality‑control report indicates that establishing a “subcenter enrollment verification checklist,” implementing proactive process controls, and instituting specialized management of informed consent have effectively ensured the authenticity and standardization of the data. These comprehensive data and analyses demonstrate that, even under complex organizational coordination, multicenter studies can maintain high scientific rigor, thereby laying a solid foundation for subsequent statistical analyses.

Clinical Echo: Application Validation and Optimization Insights from the Front Line

The value of this research is deeply rooted in clinical practice. At the conference, four experts from diverse subspecialties shared their experiences with the CNCRS in real-world settings; these insights proved indispensable for refining the scale and facilitating its implementation.

Neurosurgical Perspective (Professor He Jianghong, Beijing Tiantan Hospital):

Professor He pointed out that the CNCRS’s standardized assessment provides an objective and valuable reference for surgical patient selection and prognosis prediction. He also suggested that, in the future, scoring guidelines for certain domains—such as emotional well-being and swallowing—could be further refined to minimize inter-rater subjectivity, while expressing hope that unified, high-quality data will enable the generation of high‑level evidence‑based findings.

From the Perspective of Rehabilitation Medicine (Dr. Zou Leyao, Team of Professor Feng Zhen, Affiliated Rehabilitation Hospital of Nanchang University):

The core role of the CNCRS in comprehensive rehabilitation management was underscored, with its dynamic assessment facilitating the precise formulation and timely adjustment of wake‑promoting rehabilitation strategies. The team also candidly acknowledged how, in the project’s early stages, factors such as the need to refine protocol interpretation and internal hospital adjustments impeded enrollment rates, highlighting the complexities inherent in real‑world research.
 

From the Perspective of Critical Care Rehabilitation (Professor Wan Chunxiao, General Hospital of Tianjin Medical University):

This paper describes the experience of efficiently enrolling patients into the study by establishing a green pathway for comatose patients, while strictly adhering to the study protocol, and explores the potential of the CNCRS in early assessment and prognosis prediction within the intensive care unit (ICU).

Neuromodulation and the Perspective of Research Design (Professor Zhang Wenbin, Nanjing Brain Hospital):

The study presented a rigorous research design that, in a limited case series, employed independent assessments by A- and B‑group raters and incorporated multimodal techniques, including electroencephalography, for cross-validation, thereby underscoring the scale’s value in precisely evaluating the efficacy of neuromodulation.

In addition, Professor Yan Tiebin, an expert on the Standards Committee of the Chinese Association of Rehabilitation Medicine, commended the initiative from the perspective of standard-setting in the field, noting that the CNCRS has taken a crucial step—from hospital‑based scales to national standards and, ultimately, to participation in international dialogue. He recommended that future research incorporate a broader range of neurological conditions and conduct more rigorous validation, including assessments of test–retest reliability, to enhance the scale’s scholarly robustness and clinical credibility.

Ideas in Collision: Jointly Discussing the Commercialization of Research Outcomes, with a Focus on “Standards” and “Implementation”

The subsequent “Special Symposium on Research-to-Practice Translation” brought the conference to a climax. Experts in attendance engaged in a 50-minute, in-depth exchange and consensus-building around two core themes:

1. “Going Up”: Setting Standards and Voicing China’s Perspective:

Experts unanimously agree that the immediate priority is to translate existing findings into industry‑recognized technical standards. Professor Feng Zhen and others emphasize that CNCRS should be progressively advanced—from a multi‑center research consensus—into group standards, industry standards, and ultimately national standards, thereby establishing it as a legally binding reference for clinical diagnosis and treatment, health‑insurance reimbursement, and even research design. At the same time, a systematic framework for an academic publication portfolio is needed: after completing comprehensive data analysis and publishing high‑quality English‑language flagship papers, each participating center should be encouraged to generate sub‑studies based on its own unique data, creating a cluster effect and amplifying the “China Standard” on the international academic stage.

2. “Drive” implementation downward to benefit clinical patients:

The vitality of a standard lies in its application. Experts are keenly aware that there remains a long way to go from “paper‑based standards” to “clinical routine.” Professor Li Hongling and her colleagues emphasized the need to address the issue of assessment consistency across different raters and over time. To this end, the conference reached a clear consensus on next steps: launching a nationwide, tiered training system for the implementation of the CNCRS, linking scale development with updates to clinical practice guidelines, and exploring strategies for its widespread adoption across healthcare facilities at all levels—particularly at the primary care level—to ensure both accessibility and sustainability.

Looking Ahead: The Missionary Journey from the “Nanjing Standard” to the “National Standard”

In his closing remarks, Gao Zhiqiang, Executive Vice President of Nanjing Zijin Hospital, once again expressed his gratitude for the selfless dedication of all participating institutions. He stated that the expert consensus published in the Chinese Journal of Rehabilitation Medicine serves as an academic cornerstone for the work undertaken thus far, while this Shenzhen conference marks a strategic starting point toward broad clinical implementation. As the initiating institution, Nanjing Zijin Hospital will remain committed to sustained investment and the principle of “long-termism,” striving not only for academic excellence but also shouldering the social responsibility of advancing the entire field.

In his concluding remarks, Ge Jiangping, President of Nanjing Zijin Hospital, reflected that, from its initial conception in 1996 to 2026, and after being refined by data from 1,540 cases nationwide, the CNCRS has evolved from a “Nanjing ruler” born on the banks of the Yangtze River into a landmark achievement on China’s path of independent innovation in the field of disorders of consciousness. Though the road ahead remains long, the direction is already clear: By harnessing the collective expertise of the field, we will refine the CNCRS into a precision instrument that rivals any international scale; through systematic translation and dissemination of research findings, this uniquely Chinese “standard” will truly serve the entire nation, supporting the accurate assessment and rehabilitation of every patient with disorders of consciousness, ultimately realizing the ultimate vision of a hopeful return to awareness.

As dusk deepened, the conference hall remained brightly lit. From 1996 to 2026, from Nanjing to Shenzhen, and from a single clinical concept to 1,540 empirical cases, the journey of the Chinese Nanjing Scale for the Assessment of Consciousness Recovery stands as a vivid testament to China’s path of independent innovation in the field of disorders of consciousness. Today, this measuring tool—honed along the banks of the Yangtze River for nearly three decades—is becoming ever more precise and robust through the rigorous refinement of multi-center studies nationwide. Originating in Nanjing, it carries the hopes of countless clinicians and patient families, reaching out toward broader horizons.