The FOUR Score is a clinical grading scale designed for use by medical professionals in the assessment of patients with impaired level of consciousness.
Wijdicks and colleagues in Neurocritical care at the Mayo Clinic in Rochester, Minnesota.
The rationale for the development of the FOUR Score constituted creation of a clinical grading scale for the assessment of patients with impaired level of consciousness that can be used in patients with or without endotracheal intubation.
The main clinical grading scale in use for patients with impaired level of consciousness has historically been the Glasgow Coma Scale (GCS), which cannot be administered to patients with an endotracheal tube (one component of the GCS is the assessment of verbal responses, which are not possible in the presence of an endotracheal tube).
[5] Overall, FOUR score has better biostatistical properties than Glasgow Coma Scale in terms of sensitivity, specificity, accuracy and positive predictive value.