The Delirium Interview as a new reference standard in studies on delirium assessment tools
Background The reference standard in studies on delirium assessment tools is usually based on the clinical judgment of only one delirium expert and may be concise, unstandardized, or not specified at all. This multicenter study investigated the performance of the Delirium Interview, a new reference...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2023-06, Vol.71 (6), p.1923-1930 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 71 |
| creator | Ditzel, Fienke L. Slooter, Arjen J. C. Boogaard, Mark Boonstra, Michel Nesselrooij, Timotheus A. Kromkamp, Marjan Pop‐Purceleanu, Monica Rood, Paul J. T. Osse, Robert Jan Chan, Carol K. MacLullich, Alasdair M. J. Tieges, Zoë Neufeld, Karin J. Hut, Suzanne C. A. |
| description | Background
The reference standard in studies on delirium assessment tools is usually based on the clinical judgment of only one delirium expert and may be concise, unstandardized, or not specified at all. This multicenter study investigated the performance of the Delirium Interview, a new reference standard for studies on delirium assessment tools allowing classification of delirium based on written reports.
Methods
We tested the diagnostic accuracy of our standardized Delirium Interview by comparing delirium assessments of the reported results with live assessments. Our reference, the live assessment, was performed by two delirium experts and one well‐trained researcher who registered the results. Their delirium assessment was compared to the majority vote of three other independent delirium experts who judged the rapportage of the Delirium Interview. Our total pool consisted of 13 delirium experts with an average of 13 ± 8 years of experience.
Results
We included 98 patients (62% male, mean age 69 ± 12 years), of whom 56 (57%) intensive care units (ICUs) patients, 22 (39%) patients with a Richmond Agitation Sedation Scale (RASS) |
| doi_str_mv | 10.1111/jgs.18263 |
| format | Article |
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The reference standard in studies on delirium assessment tools is usually based on the clinical judgment of only one delirium expert and may be concise, unstandardized, or not specified at all. This multicenter study investigated the performance of the Delirium Interview, a new reference standard for studies on delirium assessment tools allowing classification of delirium based on written reports.
Methods
We tested the diagnostic accuracy of our standardized Delirium Interview by comparing delirium assessments of the reported results with live assessments. Our reference, the live assessment, was performed by two delirium experts and one well‐trained researcher who registered the results. Their delirium assessment was compared to the majority vote of three other independent delirium experts who judged the rapportage of the Delirium Interview. Our total pool consisted of 13 delirium experts with an average of 13 ± 8 years of experience.
Results
We included 98 patients (62% male, mean age 69 ± 12 years), of whom 56 (57%) intensive care units (ICUs) patients, 22 (39%) patients with a Richmond Agitation Sedation Scale (RASS) < 0 and 26 (27%) non‐verbal assessments. The overall prevalence of delirium was 28%. The Delirium Interview had a sensitivity of 89% (95% confidence interval [CI]: 71%–98%) and specificity of 82% (95% CI: 71%–90%), compared to the diagnosis of an independent panel of two delirium experts and one researcher who examined the patients themselves. Negative and positive predictive values were 95% (95% CI: 86%–0.99%), respectively, 66% (95% CI: 49%–80%). Stratification into ICU and non‐ICU patients yielded similar results.
Conclusion
The Delirium Interview is a feasible reference method for large study cohorts evaluating delirium assessment tools since experts could assess delirium with high accuracy without seeing the patient at the bedside.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.18263</identifier><identifier>PMID: 36807119</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>cognitive assessment ; Critical thinking ; Delirium ; Elder care ; Intensive care ; Intensive care units ; Medical diagnosis ; neuropsychological tests ; Physical examinations ; reference standard</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2023-06, Vol.71 (6), p.1923-1930</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.</rights><rights>2023 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3883-b5426478a838eae0895c0d7387656bb8e936ae76dd9886a7ac02c2d9530500233</citedby><cites>FETCH-LOGICAL-c3883-b5426478a838eae0895c0d7387656bb8e936ae76dd9886a7ac02c2d9530500233</cites><orcidid>0000-0003-2011-9917</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.18263$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.18263$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36807119$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ditzel, Fienke L.</creatorcontrib><creatorcontrib>Slooter, Arjen J. C.</creatorcontrib><creatorcontrib>Boogaard, Mark</creatorcontrib><creatorcontrib>Boonstra, Michel</creatorcontrib><creatorcontrib>Nesselrooij, Timotheus A.</creatorcontrib><creatorcontrib>Kromkamp, Marjan</creatorcontrib><creatorcontrib>Pop‐Purceleanu, Monica</creatorcontrib><creatorcontrib>Rood, Paul J. T.</creatorcontrib><creatorcontrib>Osse, Robert Jan</creatorcontrib><creatorcontrib>Chan, Carol K.</creatorcontrib><creatorcontrib>MacLullich, Alasdair M. J.</creatorcontrib><creatorcontrib>Tieges, Zoë</creatorcontrib><creatorcontrib>Neufeld, Karin J.</creatorcontrib><creatorcontrib>Hut, Suzanne C. A.</creatorcontrib><title>The Delirium Interview as a new reference standard in studies on delirium assessment tools</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Background
The reference standard in studies on delirium assessment tools is usually based on the clinical judgment of only one delirium expert and may be concise, unstandardized, or not specified at all. This multicenter study investigated the performance of the Delirium Interview, a new reference standard for studies on delirium assessment tools allowing classification of delirium based on written reports.
Methods
We tested the diagnostic accuracy of our standardized Delirium Interview by comparing delirium assessments of the reported results with live assessments. Our reference, the live assessment, was performed by two delirium experts and one well‐trained researcher who registered the results. Their delirium assessment was compared to the majority vote of three other independent delirium experts who judged the rapportage of the Delirium Interview. Our total pool consisted of 13 delirium experts with an average of 13 ± 8 years of experience.
Results
We included 98 patients (62% male, mean age 69 ± 12 years), of whom 56 (57%) intensive care units (ICUs) patients, 22 (39%) patients with a Richmond Agitation Sedation Scale (RASS) < 0 and 26 (27%) non‐verbal assessments. The overall prevalence of delirium was 28%. The Delirium Interview had a sensitivity of 89% (95% confidence interval [CI]: 71%–98%) and specificity of 82% (95% CI: 71%–90%), compared to the diagnosis of an independent panel of two delirium experts and one researcher who examined the patients themselves. Negative and positive predictive values were 95% (95% CI: 86%–0.99%), respectively, 66% (95% CI: 49%–80%). Stratification into ICU and non‐ICU patients yielded similar results.
Conclusion
The Delirium Interview is a feasible reference method for large study cohorts evaluating delirium assessment tools since experts could assess delirium with high accuracy without seeing the patient at the bedside.</description><subject>cognitive assessment</subject><subject>Critical thinking</subject><subject>Delirium</subject><subject>Elder care</subject><subject>Intensive care</subject><subject>Intensive care units</subject><subject>Medical diagnosis</subject><subject>neuropsychological tests</subject><subject>Physical examinations</subject><subject>reference standard</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kE1P3DAQhq2qqCwfB_5AZamXcgj4I7Enx4rCdhESB-DCxfLGA80qcagn6Yp_j-kuPSAxl5nDM69mHsaOpDiRuU5Xj3QiQRn9ic1kpVVRlbL6zGZCCFWAkeUu2yNaCSGVAPjCdrUBYaWsZ-z-9jfyn9i1qZ16vogjpr8trrkn7nnMQ8IHTBgb5DT6GHwKvI15nkKLxIfIw9uyJ0KiHuPIx2Ho6IDtPPiO8HDb99ndxfnt2a_i6nq-OPtxVTQaQBfLqlSmtOBBA3oUUFeNCFaDNZVZLgFrbTxaE0INYLz1jVCNCnWlRZX_03qffd_kPqXhz4Q0ur6lBrvORxwmcspaqG2dW0a_vUNXw5Rivs4pUKWWpZEyU8cbqkkDURbgnlLb-_TspHCvwl0W7v4Jz-zXbeK07DH8J98MZ-B0A6zbDp8_TnKX85tN5AsBs4ih</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Ditzel, Fienke L.</creator><creator>Slooter, Arjen J. C.</creator><creator>Boogaard, Mark</creator><creator>Boonstra, Michel</creator><creator>Nesselrooij, Timotheus A.</creator><creator>Kromkamp, Marjan</creator><creator>Pop‐Purceleanu, Monica</creator><creator>Rood, Paul J. T.</creator><creator>Osse, Robert Jan</creator><creator>Chan, Carol K.</creator><creator>MacLullich, Alasdair M. J.</creator><creator>Tieges, Zoë</creator><creator>Neufeld, Karin J.</creator><creator>Hut, Suzanne C. A.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2011-9917</orcidid></search><sort><creationdate>202306</creationdate><title>The Delirium Interview as a new reference standard in studies on delirium assessment tools</title><author>Ditzel, Fienke L. ; Slooter, Arjen J. C. ; Boogaard, Mark ; Boonstra, Michel ; Nesselrooij, Timotheus A. ; Kromkamp, Marjan ; Pop‐Purceleanu, Monica ; Rood, Paul J. T. ; Osse, Robert Jan ; Chan, Carol K. ; MacLullich, Alasdair M. J. ; Tieges, Zoë ; Neufeld, Karin J. ; Hut, Suzanne C. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3883-b5426478a838eae0895c0d7387656bb8e936ae76dd9886a7ac02c2d9530500233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>cognitive assessment</topic><topic>Critical thinking</topic><topic>Delirium</topic><topic>Elder care</topic><topic>Intensive care</topic><topic>Intensive care units</topic><topic>Medical diagnosis</topic><topic>neuropsychological tests</topic><topic>Physical examinations</topic><topic>reference standard</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ditzel, Fienke L.</creatorcontrib><creatorcontrib>Slooter, Arjen J. C.</creatorcontrib><creatorcontrib>Boogaard, Mark</creatorcontrib><creatorcontrib>Boonstra, Michel</creatorcontrib><creatorcontrib>Nesselrooij, Timotheus A.</creatorcontrib><creatorcontrib>Kromkamp, Marjan</creatorcontrib><creatorcontrib>Pop‐Purceleanu, Monica</creatorcontrib><creatorcontrib>Rood, Paul J. T.</creatorcontrib><creatorcontrib>Osse, Robert Jan</creatorcontrib><creatorcontrib>Chan, Carol K.</creatorcontrib><creatorcontrib>MacLullich, Alasdair M. J.</creatorcontrib><creatorcontrib>Tieges, Zoë</creatorcontrib><creatorcontrib>Neufeld, Karin J.</creatorcontrib><creatorcontrib>Hut, Suzanne C. A.</creatorcontrib><collection>Wiley Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ditzel, Fienke L.</au><au>Slooter, Arjen J. C.</au><au>Boogaard, Mark</au><au>Boonstra, Michel</au><au>Nesselrooij, Timotheus A.</au><au>Kromkamp, Marjan</au><au>Pop‐Purceleanu, Monica</au><au>Rood, Paul J. T.</au><au>Osse, Robert Jan</au><au>Chan, Carol K.</au><au>MacLullich, Alasdair M. J.</au><au>Tieges, Zoë</au><au>Neufeld, Karin J.</au><au>Hut, Suzanne C. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Delirium Interview as a new reference standard in studies on delirium assessment tools</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2023-06</date><risdate>2023</risdate><volume>71</volume><issue>6</issue><spage>1923</spage><epage>1930</epage><pages>1923-1930</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><abstract>Background
The reference standard in studies on delirium assessment tools is usually based on the clinical judgment of only one delirium expert and may be concise, unstandardized, or not specified at all. This multicenter study investigated the performance of the Delirium Interview, a new reference standard for studies on delirium assessment tools allowing classification of delirium based on written reports.
Methods
We tested the diagnostic accuracy of our standardized Delirium Interview by comparing delirium assessments of the reported results with live assessments. Our reference, the live assessment, was performed by two delirium experts and one well‐trained researcher who registered the results. Their delirium assessment was compared to the majority vote of three other independent delirium experts who judged the rapportage of the Delirium Interview. Our total pool consisted of 13 delirium experts with an average of 13 ± 8 years of experience.
Results
We included 98 patients (62% male, mean age 69 ± 12 years), of whom 56 (57%) intensive care units (ICUs) patients, 22 (39%) patients with a Richmond Agitation Sedation Scale (RASS) < 0 and 26 (27%) non‐verbal assessments. The overall prevalence of delirium was 28%. The Delirium Interview had a sensitivity of 89% (95% confidence interval [CI]: 71%–98%) and specificity of 82% (95% CI: 71%–90%), compared to the diagnosis of an independent panel of two delirium experts and one researcher who examined the patients themselves. Negative and positive predictive values were 95% (95% CI: 86%–0.99%), respectively, 66% (95% CI: 49%–80%). Stratification into ICU and non‐ICU patients yielded similar results.
Conclusion
The Delirium Interview is a feasible reference method for large study cohorts evaluating delirium assessment tools since experts could assess delirium with high accuracy without seeing the patient at the bedside.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36807119</pmid><doi>10.1111/jgs.18263</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2011-9917</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2023-06, Vol.71 (6), p.1923-1930 |
| issn | 0002-8614 1532-5415 |
| language | eng |
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| source | Wiley-Blackwell Journals |
| subjects | cognitive assessment Critical thinking Delirium Elder care Intensive care Intensive care units Medical diagnosis neuropsychological tests Physical examinations reference standard |
| title | The Delirium Interview as a new reference standard in studies on delirium assessment tools |
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