Sensitivity and Specificity of Full Outline of Unresponsiveness Score and Glasgow Coma Scale towards Patients’ Outcomes at the Intensive Care Units

Study Objective: Glasgow Coma Scale (GCS) is an instrument which is generally used to assess the patients' level of consciousness.However, in certain patients, the GCS cannot function properly to assess the patients' verbal responses.To enhance this instrument, the Full Outline of unresponsiveness (FOUR) score was therefore developed.This study aimed to determine the sensitivity and specificity of the FOUR score and the GCS in assessing the level of consciousness towards the outcomes of the patients in the ICUs.Design: observational study. Method and Measurement:The population was all patients admitted to the ICUs.The samples were 74 patients and 2 nurse observers who were selected using a consecutive sampling technique.The data were statistically analyzed using the Receiver Operating Characteristics (ROC) and the 2x2 table.Result: The results of the GCS test showed that the scores of sensitivity and specificity were 0.722 and 0.737 consecutively.Meanwhile, the FOUR showed a score of sensitivity and specificity of 0.861 and 0.816.The Area Under Cover (AUC) scores of the GCS and the FOUR were 0.859 and 0.893 consecutively towards the outcomes of the patients in the ICUs.Value of the sensitivity and specificity of the FOUR score higher than the GCS and sensitivity FOUR score higher than specificity.Conclusion: The scores of sensitivity and specificity of the FOUR were higher than the GCS.The FOUR instrument can be used as an replace of the GCS to assess the level of consciousness towards the patients' outcomes in the ICUs.