Gill-Thwaites H, Munday R. The Sensory Modality Assessment and Rehabilitation Technique (SMART): a valid and reliable assessment for vegetative state and minimally conscious state patients.
Brain Inj 2005;
18:1255-69. [PMID:
15666569 DOI:
10.1080/02699050410001719952]
[Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PRIMARY OBJECTIVE
To establish the reliability and validity of the Sensory Modality Assessment and Rehabilitation Technique (SMART) as a tool for discriminating awareness in patients with profound brain damage.
RESEARCH DESIGN
A comparative prospective study was conducted.
METHOD AND PROCEDURES
Sixty subjects diagnosed in vegetative state (VS) on admission were assessed at 2-monthly intervals. Rancho level ratings derived from referring physicians, SMART and Western Neuro Sensory Stimulation Profile (WNSSP) scores were compared.
MAIN OUTCOMES AND RESULTS
The intra-observer intra class correlation (ICC) was 0.97 and inter-observer ICC was 0.96, implying very little within and between observer scoring variations. A modest, although significant correlation was established between SMART and either physician or WNSSP scores. However, the correlation between the WNSSP and SMART was higher (r = 0.70) than that between WNSSP and physicians scores (r = 0.451) or between SMART and physicians (r= 0.474).
CONCLUSION
SMART is a valid and reliable assessment for discriminating awareness in VS and Minimally Conscious State (MCS).
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