This is a part of podcast series from the Model Systems Knowledge Translation Center on Disorders of Consciousness. Beth Hansen explains why objective data is essential in rehabilitation for people with disorders of consciousness. 

Having objective data is essential to our ability to give families a real picture of how their patient or loved one is progressing. Without this objective data, it's really just, oh, I saw them do this. Oh, I saw them do that. And without following it in a detailed manner that collects data, we are unable to develop a good communication tool for these folks based on what we have seen them able to do. So this data allows us to again, have an objective conversation with families. We can show them the progress or maybe the lack of progress that's being made and help them to make better plans for the future as well.

When we set up a tracking system for individual patients, we do notice and identify something that they do consistently; and then we're looking for that to happen over time. For example, the thumbs up or thumbs down. If they're doing that fairly consistently, we can ask them questions. We can ask them pretty basic yes/no questions. We can increase the complexity of the questions. And again, we're looking for do they actually do the thumbs up? And then do they get the answer to the question correct? If we track that over time, then we know we're on the right track for developing the communication tool.  

And then the gold standard of assessment for this patient population is the Coma Recovery Scale - Revised. And within that, there are several subscales, and these also guide us to know where the patient is heading. So again, looking at that command following, looking at functional object use. So do they know how to use a comb? Can they demonstrate that … is a really nice example. So those things will show us over time how a patient's consciousness is progressing. 

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