Hospitals may soon have access to a pioneering system of predicting when a patient is about to emerge from a deep coma, following the development of a new test.

In trials at London's Royal Hospital for Neuro-disability, the test identified six patients who came out of a persistent vegetative state (PVS) within two years.

Now the therapy team plans to publish guidance on the programme for other hospitals.

Rosie Johnson recovered from a persistent vegetative state

The technique, known as Smart (Sensory Modality Assessment and Rehabilitation Tool), could help doctors and relatives make life or death decisions about the chances of recovery for PVS patients.

At present, courts are increasingly being asked to rule on whether a PVS patient kept alive by artificial feeding should be allowed to die.

Smart can make it clear when the withdrawal of life-sustaining treatment is not an option.

It can also tell doctors the right time to apply concentrated stimulation that might bring the patient out of a coma.

The procedure involves systematically stimulating each of seven "modalities" - sight, hearing, touch, smell, taste, movement and communication - while looking for signs of returning awareness.

Pioneering work at the Royal Hospital for Neuro-disability may be adopted nationwide

Hearing, for instance, can be stimulated by blowing a whistle. Responses are graded from one (no response) to five (discriminatory response), which is classified as emergence.

They include reflex actions like blinking.

A total of 30 patients were investigated using Smart. The researchers found that six patients who eventually emerged all had scores that improved threefold or more in at least one modality.

Psychologist Dr Sarah Wilson, from the University of Surrey at Guildford, who worked on the study with the Royal Hospital, said: "It's the first time anybody has been able to differentiate between outcome groups in this way."

However, a low change score does not necessarily mean a patient is never going to recover.

So far, Smart has only been employed at the Royal Hospital but it may be more widespread soon.

Back to top | BBC News Home | BBC Homepage	©