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Cross-cultural adaptation and clinical validation of the Spanish version of the Simplified Evaluation of Consciousness Disorder (SECONDs);

Authors

Noé E. , Llorens R. , Colomer C. , Navarro M.D. , ÓValle M. , Barra A. , GALVAO CARMONA, ALEJANDRO, Moliner B. , Ferri J.

External publication

No

Means

Neurologia

Scope

Article

Nature

Científica

JCR Quartile

2

SJR Quartile

3

Publication date

01/01/2026

Scopus Id

2-s2.0-105045662360

Abstract

Introduction: The Simplified Evaluation of Disorders of Consciousness (SECONDs) has been proposed as a brief and efficient tool for the accurate diagnosis of patients with prolonged disorders of consciousness (DoC). Previous validation studies have only compared its total score with that of the Coma Recovery Scale-Revised (CRS-R). Our objective was to validate the Spanish version of the SECONDs, including its additional index, and to compare it with other scales such as the Disability Rating Scale (DRS). Materials and methods: Thirty-two patients with prolonged DoC were included. Each patient was assessed using the CRS-R, DRS, and SECONDs on two consecutive days. The SECONDs was translated into Spanish following the methodology proposed by Beaton et al. (2000). Diagnostic agreement (weighted kappa coefficient) and inter-scale correlations (Spearman's rho) were analyzed. Results: The SECONDs showed excellent agreement with the CRS-R (? = 0.81-0.83) and high intra- and inter-rater reliability (? = 0.70-0.77). Administration time was significantly shorter than that of the CRS-R (7.2 ± 1.4 vs. 16.6 ± 2.4 minutes; P<.001). Correlation with the DRS was moderate (r = –0.5 to –0.64). Conclusions: The SECONDs is a valid, reliable, and rapid tool for assessing patients with DoC in Spanish-speaking populations. Although it does not replace the CRS-R, its brevity makes it ideal for use in critical care settings or as an initial screening instrument, optimizing resources and clinical time. © 2026 Sociedad Española de Neurología

Keywords

Consciousness; Minimally conscious state; Unresponsive wakefulness syndrome; Validation