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Attention! A good bedside test for delirium?

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dc.contributor.author O'Regan, Niamh A.
dc.contributor.author Ryan, Daniel James
dc.contributor.author Boland, Eve
dc.contributor.author Connolly, Warren
dc.contributor.author McGlade, Ciara
dc.contributor.author Leonard, Maeve
dc.contributor.author Clare, Josie
dc.contributor.author Eustace, Joseph A.
dc.contributor.author Meagher, David
dc.contributor.author Timmons, Suzanne
dc.date.accessioned 2018-12-06T11:17:19Z
dc.date.available 2018-12-06T11:17:19Z
dc.date.issued 2014
dc.identifier.uri http://hdl.handle.net/10344/7395
dc.description peer-reviewed en_US
dc.description.abstract Background Routine delirium screening could improve delirium detection, but it remains unclear as to which screening tool is most suitable. We tested the diagnostic accuracy of the following screening methods (either individually or in combination) in the detection of delirium: MOTYB (months of the year backwards); SSF (Spatial Span Forwards); evidence of subjective or objective 'confusion'.Methods We performed a cross-sectional study of general hospital adult inpatients in a large tertiary referral hospital. Screening tests were performed by junior medical trainees. Subsequently, two independent formal delirium assessments were performed: first, the Confusion Assessment Method (CAM) followed by the Delirium Rating Scale-Revised 98 (DRS-R98). DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) criteria were used to assign delirium diagnosis. Sensitivity and specificity ratios with 95% CIs were calculated for each screening method.Results 265 patients were included. The most precise screening method overall was achieved by simultaneously performing MOTYB and assessing for subjective/objective confusion (sensitivity 93.8%, 95% CI 82.8 to 98.6; specificity 84.7%, 95% CI 79.2 to 89.2). In older patients, MOTYB alone was most accurate, whereas in younger patients, a simultaneous combination of SSF (cutoff 4) with either MOTYB or assessment of subjective/objective confusion was best. In every case, addition of the CAM as a second-line screening step to improve specificity resulted in considerable loss in sensitivity.Conclusions Our results suggest that simple attention tests may be useful in delirium screening. MOTYB used alone was the most accurate screening test in older people. en_US
dc.language.iso eng en_US
dc.relation.ispartofseries Journal Of Neurology Neurosurgery And Psychiatry;85,pp. 1122-1131
dc.subject confusion assessment method en_US
dc.subject emergency-department patients en_US
dc.subject mental state examination en_US
dc.subject rating scale en_US
dc.title Attention! A good bedside test for delirium? en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.date.updated 2018-12-06T10:18:52Z
dc.description.version PUBLISHED
dc.identifier.doi 10.1136/jnnp-2013-307053
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 1575681
dc.internal.copyrightchecked Yes
dc.identifier.journaltitle Journal Of Neurology Neurosurgery And Psychiatry
dc.description.status peer-reviewed


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