Validation of the Hungarian version of the Coma Recovery Scale-Revised in patients with disorders of consciousness

Objective Our objective was to validate the Hungarian version of the Coma Recovery Scale-Revised (CRS-R). Design We conducted a multicenter study across neurology, intensive care, neuro-rehabilitation, and nursing departments in Hungary. Thirty-one patients (17 males; mean age 49.1 ± 16.1 years) with disorders of consciousness (DOC) following severe acquired brain injury were assessed. Two independent raters reassessed the same patients within a one-week window to evaluate inter-rater and intra-rater reliability. We assessed reliability using weighted Cohen’s Kappa and evaluated concurrent validity using Spearman’s rank correlation. Results Concurrent validity with the Glasgow Coma Scale (GCS) was strong across all raters and time points (rho = 0.882–0.934, p < 0.001). Inter-rater reliability for the total score was excellent at initial assessment (wk = 0.977) and remained high at follow-up (wk = 0.977). Diagnostic classification agreement between raters was nearly perfect (wk = 0.936–1.000). Conclusion The Hungarian CRS-R is a valid and reliable instrument that preserves the robustness of the original version. Its implementation fills a critical gap in national healthcare by providing an evidence-based tool to reduce DOC misdiagnosis rates.