The Wessex Head Injury Matrix (WHIM) accurately assesses:
- patients in and emerging from coma
- patients in the vegetative and minimally conscious states.
Vegetative patient 'communicates'
The recent vegetative patient reported in Science and also featured on the BBC website was assessed on the WHIM.
This patient was unable to respond behaviourally but could respond neurally when asked to imagine she was playing tennis while being scanned with fMRI.
This illustrates how we need behavioural, imaging and neurophysiological measures when assessing patients in states of reduced consciousness.
With the WHIM patients can be assessed and goals for rehabilitation set from the outset of coma.
The WHIM bridges the gap between tests available for the very acute stages after head injury and those helpful in later stages of recovery.
Improvements from the initial state of coma may be gradual and, unless accurate assessment takes place, small gains may be missed or misinterpreted.
The WHIM will pick up minute indices demonstrating recovery, providing objective evidence for realistic prediction. It is easy and quick to administer by any qualified member of a multidisciplinary team.
The WHIM provides a sequential framework of observation covering:
- communication ability
- cognitive skills
- social interaction.
The 62 item observational matrix collects data by observation and by testing tasks used in everyday life.
It focuses on what the patient does or does not do rather than upon clinical diagnostic features.
The tightly defined categories of observation contained in the WHIM overcome the limitations of previously published scales which, amongst other drawbacks, are largely dependent upon subjective views.