Doctors predict recovery from vegetative state

A new test may soon enable hospitals to predict when a patient is about to emerge from a vegetative state. Our correspondent investigates.

The test devised at the Royal Hospital for Neurodisability in London looked at 13 patients who came out of a persistent vegetative state (PVS). Now the therapy team hopes to publish guidance on the programme for the benefit of other hospitals.

The technique, known as Smart (Sensory Modality Assessment and Rehabilitation Tool), could help make it clear when treatment should not be withdrawn and can also tell doctors the right time to apply concentrated stimulation that might bring the patient out of a coma. At present, courts are asked to rule on whether a PVS patient kept alive by artificial feeding should be allowed to die. Medical guidelines say that doctors can apply to a court to have a patient's food and hydration withdrawn after 12 months.

The test involves systematically stimulating each of seven "modalities" - sight, hearing, touch, smell, taste, movement and communication - while looking for signs of returning awareness. Hearing, for instance, can be stimulated by ringing a bell behind the patient. Responses are graded from one (no response) to five (discriminatory response) which is classified as emergence from PVS. Responses can include reflex actions like blinking, withdrawing from a repeated stimulus, or showing awareness of a direction a stimulus is coming from.

A total of 30 patients were investigated using Smart. The researchers found that seven patients emerged during the study and a further six patients emerged over the next two years. The six all had scores that improved threefold or more in at least one area.

Dr Sarah Wilson, from the University of Surrey at Guildford, who will present the team's findings at the British Psychological Society's London conference today said: "People coming out [of PVS] produced a change score of at least three, while those with a change score of two or less didn't come out. It's the first time we have been able to separate the outcome groups as cleanly as this."

Looking for such a level improvement could provide an early warning of when a patient was likely to emerge from a PVS. However, she stressed that a low change score did not necessarily mean a patient was never going to recover.

Start your day with The Independent, sign up for daily news emails
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Project and Resource Manager

Negotiable: Recruitment Genius: This fast growing experience-led technology co...

Recruitment Genius: Production Scientist

£23000 - £25000 per annum: Recruitment Genius: This company specialises in the...

Recruitment Genius: Factory Manager - Food

£45000 - £50000 per annum: Recruitment Genius: This is an excellent opportunit...

Recruitment Genius: Environmental Account Manager - Remote Working

£18000 - £22000 per annum: Recruitment Genius: This is an exciting opportunit...

Day In a Page

Homeless Veterans campaign: Donations hit record-breaking £1m target after £300,000 gift from Lloyds Bank

Homeless Veterans campaign

Donations hit record-breaking £1m target after huge gift from Lloyds Bank
Flight MH370 a year on: Lost without a trace – but the search goes on

Lost without a trace

But, a year on, the search continues for Flight MH370
Germany's spymasters left red-faced after thieves break into brand new secret service HQ and steal taps

Germany's spy HQ springs a leak

Thieves break into new €1.5bn complex... to steal taps
International Women's Day 2015: Celebrating the whirlwind wit of Simone de Beauvoir

Whirlwind wit of Simone de Beauvoir

Simone de Beauvoir's seminal feminist polemic, 'The Second Sex', has been published in short-form for International Women's Day
Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

Why would I want to employ someone I’d be happy to have as my boss, asks Simon Kelner
Confessions of a planespotter: With three Britons under arrest in the UAE, the perils have never been more apparent

Confessions of a planespotter

With three Britons under arrest in the UAE, the perils have never been more apparent. Sam Masters explains the appeal
Russia's gulag museum 'makes no mention' of Stalin's atrocities

Russia's gulag museum

Ministry of Culture-run site 'makes no mention' of Stalin's atrocities
The big fresh food con: Alarming truth behind the chocolate muffin that won't decay

The big fresh food con

Joanna Blythman reveals the alarming truth behind the chocolate muffin that won't decay
Virginia Ironside was my landlady: What is it like to live with an agony aunt on call 24/7?

Virginia Ironside was my landlady

Tim Willis reveals what it's like to live with an agony aunt on call 24/7
Paris Fashion Week 2015: The wit and wisdom of Manish Arora's exercise in high camp

Paris Fashion Week 2015

The wit and wisdom of Manish Arora's exercise in high camp
8 best workout DVDs

8 best workout DVDs

If your 'New Year new you' regime hasn’t lasted beyond February, why not try working out from home?
Paul Scholes column: I don't believe Jonny Evans was spitting at Papiss Cissé. It was a reflex. But what the Newcastle striker did next was horrible

Paul Scholes column

I don't believe Evans was spitting at Cissé. It was a reflex. But what the Newcastle striker did next was horrible
Miguel Layun interview: From the Azteca to Vicarage Road with a million followers

From the Azteca to Vicarage Road with a million followers

Miguel Layun is a star in Mexico where he was criticised for leaving to join Watford. But he says he sees the bigger picture
Frank Warren column: Amir Khan ready to meet winner of Floyd Mayweather v Manny Pacquiao

Khan ready to meet winner of Mayweather v Pacquiao

The Bolton fighter is unlikely to take on Kell Brook with two superstar opponents on the horizon, says Frank Warren
War with Isis: Iraq's government fights to win back Tikrit from militants - but then what?

Baghdad fights to win back Tikrit from Isis – but then what?

Patrick Cockburn reports from Kirkuk on a conflict which sectarianism has made intractable