| Title |
Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU
|
|---|---|
| Published in |
Journal of General Internal Medicine, October 2015
|
| DOI | 10.1007/s11606-015-3514-0 |
| Pubmed ID | |
| Authors |
Aleksandra Kuczmarska, Long H. Ngo, Jamey Guess, Margaret A. O’Connor, Laura Branford-White, Kerry Palihnich, Jacqueline Gallagher, Edward R. Marcantonio |
| Abstract |
Delirium is common in older hospitalized patients and is associated with poor outcomes, yet most cases go undetected. The best approach for systematic delirium identification outside the intensive care unit remains unknown. To conduct a comparative effectiveness study of the Confusion Assessment Method for the ICU (CAM-ICU) and the newly developed 3-minute diagnostic assessment for delirium using the Confusion Assessment Method (3D-CAM) in general medicine inpatients. Cross-sectional comparative effectiveness study. Two non-intensive care general medicine units at a single academic medical center. Hospitalized general medicine patients aged ≥75 years. Clinicians performed a reference standard assessment for delirium that included patient interviews, family interviews, and review of the medical record. An expert panel determined the presence or absence of delirium using DSM-IV criteria. Two blinded research assistants administered the CAM-ICU and the 3D-CAM in random order, and we determined their diagnostic test characteristics compared to the reference standard. Among the 101 participants (mean age 84 ± 5.5 years, 61 % women, 25 % with dementia), 19 % were classified as delirious based on the reference standard. Evaluation times for the 3D-CAM and CAM-ICU were similar. The sensitivity [95 % confidence interval (CI)] of delirium detection for the 3D-CAM was 95 % [74 %, 100 %] and for the CAM-ICU was 53 % [29 %, 76 %], while specificity was >90 % for both instruments. Subgroup analyses showed that the CAM-ICU had sensitivity of 30 % in patients with mild delirium vs. 100 % for the 3D-CAM. In this comparative effectiveness study, we found that the 3D-CAM had substantially higher sensitivity than the CAM-ICU in hospitalized older general medicine patients, and similar administration time. Therefore, the 3D-CAM may be a superior screening tool for delirium in this patient population. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 3 | 33% |
| United States | 2 | 22% |
| Unknown | 4 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 56% |
| Practitioners (doctors, other healthcare professionals) | 2 | 22% |
| Scientists | 1 | 11% |
| Science communicators (journalists, bloggers, editors) | 1 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 101 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 101 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 16 | 16% |
| Student > Doctoral Student | 11 | 11% |
| Student > Bachelor | 11 | 11% |
| Researcher | 10 | 10% |
| Other | 8 | 8% |
| Other | 20 | 20% |
| Unknown | 25 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 32% |
| Nursing and Health Professions | 23 | 23% |
| Neuroscience | 4 | 4% |
| Psychology | 3 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Other | 15 | 15% |
| Unknown | 22 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 February 2016.
All research outputs
#6,272,753
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#3,512
of 7,806 outputs
Outputs of similar age
#72,904
of 281,521 outputs
Outputs of similar age from Journal of General Internal Medicine
#16
of 50 outputs
Altmetric has tracked 23,911,072 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 7,806 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.8. This one has gotten more attention than average, scoring higher than 54% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 281,521 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.
We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.