Consensus on covert awareness: a Delphi study

Schnakers, C.; Overbeek, B.; Fullmer, N.; Teixeira, L.; Zandalasini, M.; Yatsko, K.; Morrissey, A.; Zasler, N.; Estraneo, A.

Авторы: Schnakers Caroline, Overbeek Berno, Fullmer Niko, Teixeira Liliana, Zandalasini Matteo, Yatsko Kseniia, Morrissey Ann-Marie, Zasler Nathan, Estraneo Anna
Журнал: Brain Communications
Том: 7
Номер: 6
Год издания: 2025
Издательство: Oxford University Press
Местоположение издательства: United Kingdom
Первая страница: 1
Последняя страница: 9
Номер статьи: fcaf462
DOI: 10.1093/braincomms/fcaf462
Аннотация: Identifying wilful brain activity in patients with disorders of consciousness is critical, as some patients fail to exhibit behavioural signsof consciousness at the bedside but respond to active tasks via neuroimaging or electrophysiological measures. Standardized terminology for this subgroup is absent while it is essential for advancing research and clinical care. The objective of this study was to determine the level of consensus among a large group of international experts on terminology and definitions for this clinical entity, asdescribed by terms such as covert awareness, cognitive motor dissociation, functional locked-in syndrome, and non-behavioural minimally conscious state. A Delphi study was conducted using REDCap to evaluate expert agreement on terminology and definitions.The study was conducted among international experts, primarily from Europe/UK, the USA and other regions. Ninety-six experts participated. Among these, 75 (78%) completed both rounds. Participants were predominantly clinical scientists (71%) working in rehabilitation settings (63%). A Delphi method was followed. Consensus on terminology and related definitions was defined as a medianscore of 5, an interquartile range ≤1 and ≥75% agreement (scores of 4 or 5). Within two rounds, consensus was achieved for over twothirds of the statements. The term ‘Covert Awareness’ and its associated definition were identified as the preferred terminology by aninternational expert panel. We recommend the use of ‘Covert Awareness’ since our large group of international experts consistentlyagreed on such preferred term for this subgroup of patients with disorders of consciousness. This consensus (>75% agreement) establishes a foundation both for future research and clinical standardization. The findings have implications for improving diagnostic accuracy and advancing understanding of covert awareness, although further study is needed to refine and apply the agreed-upondefinition in clinical practice.
Добавил в систему: Яцко (Ильина) Ксения Александровна

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