Abstract：
Establishing an accurate diagnosis is crucial for patients with disorders of consciousness (DoC) following a severe brain injury. The Coma Recovery Scale-Revised (CRS-R) is the recommended behavioral scale for assessing the level of consciousness among these patients, but its long duration of administration is a major hurdle in clinical settings. The Simplified Evaluation of CONsciousness Disorders (SECONDs) is a shorter scale that was developed to tackle this issue. It consists of six mandatory items, observation, command-following, visual pursuit, visual fixation, oriented behaviors, and arousal, and two conditional items, communication and localization to pain. The score ranges between 0 and 8 and corresponds to a specific diagnosis (i.e., coma, unresponsive wakefulness syndrome, minimally conscious state minus/plus, or emergence from the minimally conscious state). A first validation study on patients with prolonged DoC showed high concurrent validity and intra- and inter-rater reliability. The SECONDs requires less training than the CRS-R and its administration lasts about 7 minutes (interquartile range: 5-9 minutes). An additional index score allows the more precise tracking of a patient\'s behavioral fluctuation or evolution over time. The SECONDs is therefore a fast and valid tool for assessing the level of consciousness in patients with severe brain injury. It can easily be used by healthcare staff and implemented in time-constrained clinical settings, such as intensive care units, to help decrease misdiagnosis rates and to optimize treatment decisions. These administration guidelines provide detailed instructions for administering the SECONDs in a standardized and reproducible manner, which is an essential requirement for achieving a reliable diagnosis.
摘要：
建立准确的诊断对于严重脑损伤后意识障碍（DoC）的患者至关重要。昏迷恢复量表（CRS-R）是评估这些患者意识水平的推荐行为量表，但其长期给药是临床环境中的主要障碍。意识障碍的简化评估（第二）是为解决此问题而开发的较短的规模。它由六个强制性项目组成，观察,命令跟随，视觉追求,视觉固定，面向的行为，和唤醒，和两个条件项，沟通和定位疼痛。评分范围在0到8之间，对应于特定的诊断(即，昏迷,反应迟钝的觉醒综合症，最低意识状态减/加，或从最低意识状态出现)。对DoC延长患者的首次验证研究显示出高并发有效性以及评估者内和评估者间的可靠性。第二D比CRS-R需要更少的训练,并且其施用持续约7分钟(四分位间距:5-9分钟)。额外的指数分数允许更精确地跟踪患者的行为波动或随时间的演变。因此，SECOND是评估严重脑损伤患者意识水平的快速有效工具。它可以很容易地被医护人员使用，并在时间有限的临床环境中实施，比如重症监护病房,以帮助减少误诊率和优化治疗决策。这些管理指南提供了以标准化和可重复的方式管理第二药物的详细说明。这是实现可靠诊断的基本要求。
