Coma prognosis in children - Part I: Definitional and methodological challenges

Prediction of outcome fi;om coma is a frequent and important task of neurol ogists. It is difficult enough in adult patients and even more difficult in children. Part I of this review considers some of the methodological probl ems and caveats besetting clinical research in this field: the very definit ion of coma, definition of the study population and outcome variables, stud y design, the fallacy of self-fulfilling prophecy, early death rate from no nneurologic causes resulting in low statistical power, and invalid attempts to compensate for that by combining outcome categories, lumping together a ge groups, short and inhomogeneous follow-up, and failure to provide confid ence intervals. Part II reviews the clinical pediatric coma-prognosis liter ature, first according to etiology and then according to electrodiagnostic tests.