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Each of the nurses had more than 5 years of clinical experience in a neurological/neurosurgical [http://www.selleckchem.com/products/Ki16425.html Ki16425 price] intensive care unit (ICU) and was reinstructed in GCS and the FOUR score. Subsequently, raters were provided with a one-page handout written instruction describing both the FOUR score and the GCS and were asked to grade a few patients using both the GCS and the FOUR score scale. Interrater reliabilities for FOUR score and GCS were 0.98 and 0.96, respectively. Patients were followed up until two weeks or hospital discharge in order to record their survival status. All patients were prospectively enrolled and provided informed consent by their guardian. Comparison of the discrepancies between the scales was undertaken by cross-tabulating their prediction at a fixed decision criterion. The observed and expected numbers of deaths within each stratum were compared and their sensitivity, specificity, and accuracy were statistically evaluated by the Youden index (Table 1). For data entry and analysis, SPSS 14 was employed. Both descriptive (mean, SD, and frequency) and inferential statistics test included the Yoden index, and diagnostic values (TP, TN, FP, and FN) were used. Table 1 Youden index (J = 1 ? (�� + ��)) for explaining reveals and results interpretation. 3. Results [http://www.selleckchem.com/products/ly-411575.html LY411575] In this study 104 patients, 23 (22.15%) females and 81 (77.9%) males, with mean age of 41.38 �� 18.22 (from 17 to 86 years) [http://en.wikipedia.org/wiki/Aniracetam Aniracetam] were studied. Sensitivity of both scales was 68.4% (Table 2). GCS predicted 26 deaths accurately. The agreement between GCS and patients outcome was 30% and between FOUR scale and patients outcome was 44.9%. This agreement between two scales was 43.8% (Table 3). No relationship between sex and age was found in this regard. The Youden index showed that FOUR scale (45.7%) has a better prediction for death than GCS (32.0%). Furthermore, Kappa agreement coefficient for agreement between FOUR (P = 0.006) and GCS (P = 0.016) with patient's outcome was statistically significant (Table 3). Means of scores in dead and alive patients for GCS were 4.62 �� 2.094 and 6.58 �� 2.281, and for FOUR they were 4.7 �� 3.471 and 8.42 �� 2.925, respectively. t-test showed a significant difference between means of the alive and dead subjects in both scales (P