724 - Proof of Concept - Utilizing the ‘Coma Recovery Scale-Revised’ to Predict ‘Disability Rating Scale’ in Acute Rehabilitation of Severe Traumatic Brain Injury

Objectives: Severe TBI effects ~5.48 million individuals globally. There is a lack of functional prognostic data to provide to patients and their families. A study published by Tran et al., in July 2023 generated an equation that could objectively assign a probability that a patient with disorder of consciousness will fall into 1 of 4 DRS disability categories using the coma recovery scale (CRS-R). The purpose of the present study is to create a user-friendly mobile application that utilizes this prognostic tool.

Design: A proof of concept was developed using Xcode, Apple’s integrated development environment for macOS, with SwiftUI as the framework for building user interfaces across iOS and macOS. The tool allows users to input Coma Recovery Scale–Revised (CRS-R) scores at baseline and at four weeks. These values are then processed through equations published by Tran et al., which predict functional outcomes using the Disability Rating Scale (DRS). The system generates four probability outputs: (1) likelihood of a severe to extremely severe DRS outcome based on baseline CRS-R score, (2) likelihood of a vegetative to extremely vegetative DRS outcome based on baseline CRS-R score, (3) likelihood of a severe to extremely severe DRS outcome based on week 4 CRS-R score, and (4) likelihood of a vegetative to extremely vegetative DRS outcome based on week 4 CRS-R score.

Results:

This tool demonstrates a practical application of predictive modeling in disorders of consciousness.

Conclusions: This is the first proof of concept for a user-friendly mobile application that enables clinicians to more tangibly guide conversations with patients with severe TBI and their families about the anticipated outcomes pertaining to function, independence, and employability.