The complementary role of music therapy in the detection of awareness in disorders of consciousness: An audit of concurrent SMART and MATADOC assessments

In the behavioural assessment of disorders of consciousness (DOC), best practice
is for several different assessment tools to be used to encourage a variety of
different responses indicative of awareness. Anecdotal evidence suggests a
range of musical stimuli may be particularly effective in eliciting responses
to guide the assessment process, although comparative data regarding behavioural domains is lacking. This study examined 42 concurrent records of
patients assessed using the Sensory Modality Assessment and Rehabilitation
Technique (SMART), and the Music Therapy Assessment Tool for Awareness
in Disorders of Consciousness (MATADOC) to explore the relationship
between diagnosis and behavioural characteristics of the cohort. Whilst the
two tools produced a high level of agreement in diagnostic outcome (Spearman
Rho .80), divergent diagnosis and weaker correlations between behavioural
response items highlight contrasting sensitivities of the tools. Whilst
MATADOC has higher sensitivity within auditory and visual domains relative
to SMART, SMART has higher sensitivity in the motor domain. The significant
contribution of musical response items in MATADOC, and the tactile response