Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis
ABSTRACT Aims To synthesise the evidence on and to compare the diagnostic accuracy of the Nu‐DESC and CAM in detecting postoperative delirium among hospitalised patients. Design Systematic review and diagnostic meta‐analysis. Data Sources The PubMed, Embase, Cumulative Index to Nursing and Allied He...
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| Veröffentlicht in: | Journal of clinical nursing 2025-01, Vol.34 (1), p.287-298 |
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| container_title | Journal of clinical nursing |
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| creator | Lin, Chia‐Jou Fick, Donna Marie Traynor, Victoria Chen, Yi‐Chen Hsiang, Hui‐Fen Chiu, Hsiao‐Yean |
| description | ABSTRACT
Aims
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu‐DESC and CAM in detecting postoperative delirium among hospitalised patients.
Design
Systematic review and diagnostic meta‐analysis.
Data Sources
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
Results
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu‐DESC and CAM, respectively. For Nu‐DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu‐DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p |
| doi_str_mv | 10.1111/jocn.17467 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3110907402</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3110907402</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2467-23f8ef7ce8e808df8ddc664f0758de02fbff40552ed5fe6fcdda4236a88aa89e3</originalsourceid><addsrcrecordid>eNp9kU1u1DAYhi0EokNhwwGQJTYIKcU_ieOwi1J-VVrEANvItT8XjxJ7aietsuMIHIE9t-AonISEmbJggTeWrMfP--l7EXpIyRGdz7NN0P6Ilrkob6EV5aLIWEnYbbQilWAZJaI8QPdS2hBCOWP8LjrgFed5IcoV-tGEfquiGtwV4GOnLnxIg9O41nqMSk84WHw6xuT8BT6GzkU39nitI4BfntZadYA_Q0xjwk3wdkwueFynBCn14Af8DoYvwWAb4s_v72d32MJN2l73HNd4PaUBerUkf4ArB9dYebP8Vb--fqu96qbk0n10x6ouwYP9fYg-vXzxsXmdnZy9etPUJ5lm8w4yxq0EW2qQIIk0VhqjhcgtKQtpgDB7bm1OioKBKSwIq41ROeNCSamUrIAfoic77zaGyxHS0PYuaeg65SGMqeWUkoqUOWEz-vgfdBPGOM-7ULkQnFSVnKmnO0rHkFIE226j61WcWkrapcJ2qbD9U-EMP9orx_MezF_0prMZoDvg2nUw_UfVvj1rTnfS30MqrIs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146630998</pqid></control><display><type>article</type><title>Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Lin, Chia‐Jou ; Fick, Donna Marie ; Traynor, Victoria ; Chen, Yi‐Chen ; Hsiang, Hui‐Fen ; Chiu, Hsiao‐Yean</creator><creatorcontrib>Lin, Chia‐Jou ; Fick, Donna Marie ; Traynor, Victoria ; Chen, Yi‐Chen ; Hsiang, Hui‐Fen ; Chiu, Hsiao‐Yean</creatorcontrib><description>ABSTRACT
Aims
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu‐DESC and CAM in detecting postoperative delirium among hospitalised patients.
Design
Systematic review and diagnostic meta‐analysis.
Data Sources
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
Results
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu‐DESC and CAM, respectively. For Nu‐DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu‐DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu‐DESC (B = −0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01).
Conclusion
The sensitivities of the Nu‐DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology‐based algorithms to enhance the screening capability is warranted.
Reporting Method
The study has adhered to PRISMA‐DTA guideline.
Patient or Public Contribution
No patient or public contribution.
Trial Registration
The study protocol has been registered on PROSPERO (CRD42023398961)</description><identifier>ISSN: 0962-1067</identifier><identifier>ISSN: 1365-2702</identifier><identifier>EISSN: 1365-2702</identifier><identifier>DOI: 10.1111/jocn.17467</identifier><identifier>PMID: 39334567</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Confusion - diagnosis ; Confusion - nursing ; Confusion Assessment Method ; Delirium ; Delirium - diagnosis ; Delirium - nursing ; diagnostic accuracy ; Diagnostic tests ; Female ; Humans ; Male ; Medical diagnosis ; meta‐analysis ; Nursing Delirium Screening Scale ; Nursing Diagnosis ; Patient assessment ; Postoperative Complications - diagnosis ; Postoperative Complications - nursing ; postoperative delirium ; Postoperative period ; Systematic review</subject><ispartof>Journal of clinical nursing, 2025-01, Vol.34 (1), p.287-298</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><rights>Copyright © 2025 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2467-23f8ef7ce8e808df8ddc664f0758de02fbff40552ed5fe6fcdda4236a88aa89e3</cites><orcidid>0000-0002-6419-9309 ; 0000-0002-6777-1913 ; 0000-0003-4515-7602</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%2Fjocn.17467$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjocn.17467$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39334567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Chia‐Jou</creatorcontrib><creatorcontrib>Fick, Donna Marie</creatorcontrib><creatorcontrib>Traynor, Victoria</creatorcontrib><creatorcontrib>Chen, Yi‐Chen</creatorcontrib><creatorcontrib>Hsiang, Hui‐Fen</creatorcontrib><creatorcontrib>Chiu, Hsiao‐Yean</creatorcontrib><title>Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis</title><title>Journal of clinical nursing</title><addtitle>J Clin Nurs</addtitle><description>ABSTRACT
Aims
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu‐DESC and CAM in detecting postoperative delirium among hospitalised patients.
Design
Systematic review and diagnostic meta‐analysis.
Data Sources
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
Results
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu‐DESC and CAM, respectively. For Nu‐DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu‐DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu‐DESC (B = −0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01).
Conclusion
The sensitivities of the Nu‐DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology‐based algorithms to enhance the screening capability is warranted.
Reporting Method
The study has adhered to PRISMA‐DTA guideline.
Patient or Public Contribution
No patient or public contribution.
Trial Registration
The study protocol has been registered on PROSPERO (CRD42023398961)</description><subject>Confusion - diagnosis</subject><subject>Confusion - nursing</subject><subject>Confusion Assessment Method</subject><subject>Delirium</subject><subject>Delirium - diagnosis</subject><subject>Delirium - nursing</subject><subject>diagnostic accuracy</subject><subject>Diagnostic tests</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>meta‐analysis</subject><subject>Nursing Delirium Screening Scale</subject><subject>Nursing Diagnosis</subject><subject>Patient assessment</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - nursing</subject><subject>postoperative delirium</subject><subject>Postoperative period</subject><subject>Systematic review</subject><issn>0962-1067</issn><issn>1365-2702</issn><issn>1365-2702</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1u1DAYhi0EokNhwwGQJTYIKcU_ieOwi1J-VVrEANvItT8XjxJ7aietsuMIHIE9t-AonISEmbJggTeWrMfP--l7EXpIyRGdz7NN0P6Ilrkob6EV5aLIWEnYbbQilWAZJaI8QPdS2hBCOWP8LjrgFed5IcoV-tGEfquiGtwV4GOnLnxIg9O41nqMSk84WHw6xuT8BT6GzkU39nitI4BfntZadYA_Q0xjwk3wdkwueFynBCn14Af8DoYvwWAb4s_v72d32MJN2l73HNd4PaUBerUkf4ArB9dYebP8Vb--fqu96qbk0n10x6ouwYP9fYg-vXzxsXmdnZy9etPUJ5lm8w4yxq0EW2qQIIk0VhqjhcgtKQtpgDB7bm1OioKBKSwIq41ROeNCSamUrIAfoic77zaGyxHS0PYuaeg65SGMqeWUkoqUOWEz-vgfdBPGOM-7ULkQnFSVnKmnO0rHkFIE226j61WcWkrapcJ2qbD9U-EMP9orx_MezF_0prMZoDvg2nUw_UfVvj1rTnfS30MqrIs</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>Lin, Chia‐Jou</creator><creator>Fick, Donna Marie</creator><creator>Traynor, Victoria</creator><creator>Chen, Yi‐Chen</creator><creator>Hsiang, Hui‐Fen</creator><creator>Chiu, Hsiao‐Yean</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6419-9309</orcidid><orcidid>https://orcid.org/0000-0002-6777-1913</orcidid><orcidid>https://orcid.org/0000-0003-4515-7602</orcidid></search><sort><creationdate>202501</creationdate><title>Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis</title><author>Lin, Chia‐Jou ; Fick, Donna Marie ; Traynor, Victoria ; Chen, Yi‐Chen ; Hsiang, Hui‐Fen ; Chiu, Hsiao‐Yean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2467-23f8ef7ce8e808df8ddc664f0758de02fbff40552ed5fe6fcdda4236a88aa89e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Confusion - diagnosis</topic><topic>Confusion - nursing</topic><topic>Confusion Assessment Method</topic><topic>Delirium</topic><topic>Delirium - diagnosis</topic><topic>Delirium - nursing</topic><topic>diagnostic accuracy</topic><topic>Diagnostic tests</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>meta‐analysis</topic><topic>Nursing Delirium Screening Scale</topic><topic>Nursing Diagnosis</topic><topic>Patient assessment</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - nursing</topic><topic>postoperative delirium</topic><topic>Postoperative period</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Chia‐Jou</creatorcontrib><creatorcontrib>Fick, Donna Marie</creatorcontrib><creatorcontrib>Traynor, Victoria</creatorcontrib><creatorcontrib>Chen, Yi‐Chen</creatorcontrib><creatorcontrib>Hsiang, Hui‐Fen</creatorcontrib><creatorcontrib>Chiu, Hsiao‐Yean</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Chia‐Jou</au><au>Fick, Donna Marie</au><au>Traynor, Victoria</au><au>Chen, Yi‐Chen</au><au>Hsiang, Hui‐Fen</au><au>Chiu, Hsiao‐Yean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis</atitle><jtitle>Journal of clinical nursing</jtitle><addtitle>J Clin Nurs</addtitle><date>2025-01</date><risdate>2025</risdate><volume>34</volume><issue>1</issue><spage>287</spage><epage>298</epage><pages>287-298</pages><issn>0962-1067</issn><issn>1365-2702</issn><eissn>1365-2702</eissn><abstract>ABSTRACT
Aims
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu‐DESC and CAM in detecting postoperative delirium among hospitalised patients.
Design
Systematic review and diagnostic meta‐analysis.
Data Sources
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
Results
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu‐DESC and CAM, respectively. For Nu‐DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu‐DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu‐DESC (B = −0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01).
Conclusion
The sensitivities of the Nu‐DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology‐based algorithms to enhance the screening capability is warranted.
Reporting Method
The study has adhered to PRISMA‐DTA guideline.
Patient or Public Contribution
No patient or public contribution.
Trial Registration
The study protocol has been registered on PROSPERO (CRD42023398961)</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39334567</pmid><doi>10.1111/jocn.17467</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6419-9309</orcidid><orcidid>https://orcid.org/0000-0002-6777-1913</orcidid><orcidid>https://orcid.org/0000-0003-4515-7602</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0962-1067 |
| ispartof | Journal of clinical nursing, 2025-01, Vol.34 (1), p.287-298 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Confusion - diagnosis Confusion - nursing Confusion Assessment Method Delirium Delirium - diagnosis Delirium - nursing diagnostic accuracy Diagnostic tests Female Humans Male Medical diagnosis meta‐analysis Nursing Delirium Screening Scale Nursing Diagnosis Patient assessment Postoperative Complications - diagnosis Postoperative Complications - nursing postoperative delirium Postoperative period Systematic review |
| title | Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta‐Analysis |
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