It is time to abandon the Glasgow Coma Scale (GCS). As discussed below, this ubiquitous neurologic scoring system is confusing, unreliable, and unnecessarily complex, and its manner of common clinical use is statistically unsound. Teasdale and Jennett devised the GCS in 1974 not for acute care, but rather for the “repeated bedside assessment” in a neurosurgical unit to detect “changing states” ...

STUDY OBJECTIVE To explore how Student's t test, which assumes normal errors, is affected by the nonnormal distribution of Glasgow Coma Scale (GCS) scores. METHODS A sample of 145,295 GCS scores from the Pennsylvania Trauma Systems Foundation was assumed to represent the true GCS distribution. Four Monte Carlo simulations, each based on 40,000 replications, were conducted to approximate the d...

2 Peterson PA, Berggard I. Urinary immunoglobulin components in normal, tubular and glomerular proteinuria: quantities and characteristics of free light chains, IgG, IgA and Fcy fragments. EurJ ClGn Invest 1971 :1:255-64. 3 Balslov JT, Brun C, Jensen KB, et al. Cytostatic treatment of glomerular diseases. Effect of azathioprine on serum and urine proteins. Report from a Copenhagen study group o...

BACKGROUND AND PURPOSE Dysphagia after intracerebral hemorrhage (ICH) contributes significantly to morbidity, often necessitating placement of a percutaneous endoscopic gastrostomy (PEG) tube. This study describes a novel risk prediction score for PEG placement after ICH. METHODS We retrospectively analyzed data from 234 patients with ICH presenting during a 4-year period. One hundred eighty-...

BACKGROUND Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed...