Comparison of SMART and WHIM as measurement tools in routine assessment of PDOC patients. Issue 8 (17th November 2018) - McAleese, Aisling
ABSTRACT: Background: Royal College of Physicians guidelines on PDOC recommended repeated assessments of patients in PDOC are undertaken by skilled clinicians. The Wessex Head Injury Matrix (WHIM) and the Sensory Modality Assessment and Rehabilitation Technique (SMART) are the most commonly used measures within UK. Objective: To evaluate the use of WHIM and SMART to identify potential changes in PDOC patients. Methods: Twelve PDOC patients admitted to a post-acute regional neuro-rehabilitation unit were assessed using WHIM and SMART. Eight of 12 patients were diagnosed with a primary hypoxic ischemic brain injury (HIBI). Results: Overall for the total group there was no significant correlation between patient's highest ranked behaviour and any SMART domain. Initial WHIM total observed behaviour was significantly correlated with SMART tactile domain. Patient's final WHIM and SMART domains were not significantly correlated. Among HIBI subgroup, initial WHIM highest ranked behaviour and WHIM total observed behaviour were significantly correlated with the SMART communication domain. Final WHIM highest ranked behaviour was positively correlated with SMART visual and tactile domains. Final WHIM total observed behaviour was significantly correlated with the SMART visual domain. Conclusions: Both measures show sensitivity to change in PDOC patients. Larger long-term follow-up of HIBI patients is highlighted.