Comorbidities Coma Scale (CoCoS): Linguistic and Cultural Adaptation of the Russian-Language Version

   Identification of complications and control of comorbidities are essential in monitoring the patients with chronic disorders of consciousness and predicting their outcomes. The researchers of the Department of Biotechnological and Applied Clinical Sciences of the University of L'Aquila (Italy) developed the Comorbidities Coma Scale (CoCoS) for a comprehensive assessment of such patients. Lack of an officially validated version of the scale hampers its use in Russia, while using versions which have not been completely validated prevents clinicians from obtaining reliable results when examining patients with chronic disorders of consciousness.
   Aim. To develop the official Russian language version of the Comorbidities Coma Scale, considering various linguistic and cultural parameters, as a part of the 1st stage of the validation study.
   Material and methods. The first stage of validation was completed: direct and reverse translation of the scale was performed by two independent medical translators. The translated version was assessed by an expert board including an expert translator, neurologists, and critical care specialists. Pilot test and two meetings of the expert board, before and after testing, were arranged to assess the results and approve the final Russian version of the scale.
   Results. During the first meeting of the expert board, corrections were made in the Russian language version of the scale in terms of language and cultural adaptation. Pilot testing was carried out based on the inclusion and exclusion criteria. The researchers had no difficulties in understanding and interpreting the instructions for the scale. The second meeting of the expert board was held thereupon, and the final version of the Russian language version of the scale was adopted, which is available on the website of the Center for Validation of Health Status Questionnaires and Scales of the Research Center of Neurology.
   Conclusion. The first stage of validation, i. e., linguistic and cultural adaptation, was carried out at the Research Center of Neurology (Moscow, Russia). For the first time, the Russian version of the scale for assessing comorbidities in patients with chronic disorders of consciousness was presented and approved for the practical use. The future publications will address the psychometric results of the scale such as sensitivity, validity, reliability.

1. Пирадов М. А. Российская рабочая группа по проблемам хронических нарушений сознания. Хронические нарушения сознания: терминология и диагностические критерии. Результаты первого заседания Российской рабочей группы по проблемам хронических нарушений сознания / М. А. Пирадов [и др.] // Анналы клинической и экспериментальной неврологии. – 2020. 14 (1): 5–16. DOI: 10.25692/ACEN.2020.1.1.

2. Laureys S., Celesia G. G., Cohadon F., Lavrijsen J., León-Carrión J., Sannita W. G., Sazbon L., Schmutzhard E., von Wild K. R., Zeman A., Dolce G; European Task Force on Disorders of Consciousness. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med. 2010; 8 (1): 2–5. DOI: 10.1186/1741-7015-8-68. PMID: 21040571. PMCID: PMC2987895

3. Giacino J. T., Katz D. I., Schiff N. D., Whyte J., Ashman E. J., Ashwal S., Barbano R., Hammond F. M., Laureys S., Ling G. S. F., Nakase-Richardson R., Seel R. T., Yablon S., Getchius T. S. D., Gronseth G. S., Armstrong M. J. Practice guideline update recommendations summary: Disorders of consciousness: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research. Neurology. 2018; 91 (10): 450–460. DOI: 10.1212/WNL.0000000000005926. PMID: 30089618.

4. De Groot V., Beckerman H., Lankhorst G. J., Bouter L. M. How to measure comorbidity: a critical review of available methods. J Clin Epidemiol. 2003; 56 (3): 221–229. DOI: 10.1016/s0895-4356(02)00585-1. PMID: 12725876.

5. Charlson M. E., Pompei P., Ales K. L., MacKenzie C. R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40 (5): 373–383. DOI: 10.1016/0021-9681(87)90171-8. PMID: 3558716.

6. Kaplan M. H., Feinstein A. R. A critique of methods in reported studies of long-term vascular complications in patients with diabetes mellitus. Diabetes. 1973 Mar; 22 (3): 160–174. DOI: 10.2337/diab.22.3.160. PMID: 4689292.

7. Greenfield S., Apolone G., McNeil B. J., Cleary P. D. The importance of co-existent disease in the occurrence of postoperative complications and one-year recovery in patients undergoing total hip replacement. Comorbidity and outcomes after hip replacement. Med Care. 1993 Feb; 31 (2): 141–154. DOI: 10.1097/00005650-199302000-00005. PMID: 8433577.

8. Rozzini R., Frisoni G. B., Ferrucci L., Barbisoni P., Sabatini T., Ranieri P., Guralnik J. M., Trabucchi M. Geriatric Index of Comorbidity: validation and comparison with other measures of comorbidity. Age Ageing. 2002 Jul; 31 (4): 277–285. DOI: 10.1093/ageing/31.4.277. PMID: 12147566.

9. Groll D. L., To T., Bombardier C., Wright J. G. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005; 58 (6): 595–602. DOI: 10.1016/j.jclinepi.2004.10.018. PMID: 15878473.

10. Preedy V. R., Watson R. R. (ed). Handbook of Diseases and a Measure of Quality of Life. New York: Springer; 2010. DOI: 10.1007/978-0-387-78665-0; ISBN: 978-0-387-78664-3

11. Whyte J., Nordenbo A. M., Kalmar K., Merges B., Bagiella E., Chang H., Yablon S., Cho S,. Hammond F., Khademi A., Giacino J. Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness. Arch Phys Med Rehabil. 2013; 94 (10): 1877–1883. DOI: 10.1016/j.apmr.2012.12.027. PMID: 23735519

12. Pistoia F., Sacco S., Franceschini M., Sarà M., Pistarini C., Cazzulani B., Simonelli I., Pasqualetti P., Carolei A. Comorbidities: a key issue in patients with disorders of consciousness. J Neurotrauma. 2015; 32 (10): 682–688. DOI: 10.1089/neu.2014.3659. PMID: 25333386

13. Pistoia F., Carolei A., Bodien Y. G., Greenfield S., Kaplan S., Sacco S., Pistarini C., Casalena A., De Tanti A., Cazzulani B., Bellaviti G., Sarà M., Giacino J. Comorbidities Coma Scale (CoCoS): Psychometric Properties and Clinical Usefulness in Patients With Disorders of Consciousness. J Front Neurol. 2019; 10: 1042. DOI: 10.3389/fneur.2019.01042. PMID 31681139

14. Пирадов М. А. Шкала комы Глазго (Glasgow Coma Scale, GCS): лингвокультурная адаптация русскоязычной версии / М. А. Пирадов [и др.] // Журнал им. Н. В. Склифосовского «Неотложная медицинская помощь». – 2021. – 10 (1): 91–99. DOI: 10.23934/2223-9022-2021-10-1-91-99.

15. Пирадов М. А. Шкала подробной оценки состояния ареактивных пациентов (Full Outline of UnResponsiveness, FOUR): лингво-культурная адаптация русскоязычной версии / М. А. Пирадов [и др.] // Анналы клинической и экспериментальной неврологии. – 2019. – 13 (3): 47–54. DOI: 10.25692/ACEN.2019.3.7.

16. Iazeva E. G., Legostaeva L. A., Zimin A. A., Sergeev D. V., Domashenko M. A., Samorukov V. Yu, Yusupova D. G., Ryabinkina Yu. V., Suponeva N. A., Piradov M. A., Bodien E. G., Giacino J. T. A Russian validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Injury. 2019; 33 (2): 218–225. DOI: 10.23934/2223-9022-2021-10-1-91-99. PMID: 30388893

17. Beaton D., Bombardier C., Guillemin, F., Ferraz M. B. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000; 25 (24): 3186–1391. DOI: 10.1097/00007632-200012150-00014. PMID: 11124735.

18. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. International Guideline Treatment of Pressure Ulcers: Quick Reference Guide. 2009 [updated 2014 Oct 16, cited 2019 Sep 05]. Available from: https://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14 ISBN-10: 0-9579343-6-X ISBN-13: 978-0-9579343-6-8