|
Measurement
|
ICU delirium tools
|
Patients’ clinician diagnosisa
|
3 Simple orientation questions
|
|---|
|
CAM-ICU
|
ICDSC
|
Physician
|
Resident
|
Nurse
|
1 false or absent response
|
2 false or absent responses
|
1 false responseb
|
2 false responsesb
|
|---|
|
Sensitivity
|
83% [71–94]
|
83% [71–94]
|
79% [65–94]
|
68% [52–83]
|
70% [54–86]
|
90% [81–99]
|
68% [54–83]
|
78% [59–97]
|
28% [7–48]
|
|
Specificity
|
100% [100–100]
|
87% [78–95]
|
85% [75–96]
|
93% [86–100]
|
89% [82–97]
|
66% [54–77]
|
82% [73–91]
|
73% [62–85]
|
92% [85–99]
|
|
PPV
|
100% [100–100]
|
79% [67–91]
|
79% [65–94]
|
85% [72–99]
|
78% [62–93]
|
62% [49–74]
|
70% [56–84]
|
47% [29–65]
|
50% [19–81]
|
|
NPV
|
91% [84–97]
|
89% [82–97]
|
85% [75–96]
|
82% [72–92]
|
85% [76–94]
|
92% [84–99]
|
81% [72–90]
|
92% [84–99]
|
81% [72–90]
|
|
Delirium diagnosis by non experts
|
31%
|
40%
|
41%
|
31%
|
31%
|
56%
|
37%
|
38%
|
13%
|
|
by experts
|
38%
|
38%
|
41%
|
39%
|
34%
|
38%
|
38%
|
21%
|
21%
|
|
Agreement with experts (κ ± SD)c
|
0.86 ± 0.05
|
0.69 ± 0.07
|
0.65 ± 0.09
|
0.63 ± 0.09
|
0.61 ± 0.09
|
0.51 ± 0.08
|
0.51 ± 0.09
|
0.41 ± 0.10
|
0.23 ± 0.13
|
- The statistical measurement of performance is expressed as the percentage and its 95% confidence interval. CAM-ICU Confusion Assessment Method for the Intensive Care Unit, ICDSC Intensive Care Delirium Screening Checklist, PPV positive predictive value, NPV negative predictive value
- aAmong the 108 patients included for analysis, patients’ clinicians were available upon study completion for 91 patient nurses (84%), 89 patient residents (82%) and 71 patient physicians (66%). Among the clinicians participating in the study, the 4 nurses, 1 resident and 1 physician who could not answer the question whether the patient was or was not delirious were not taken into account for the analysis
- bAnalysis was performed among the 78 patients (72%) who were able to answer all three simple questions
- cThe agreement between each method of delirium diagnosis and the assessment by the neuropsychological experts using DSM-5 criteria (reference standard) was measured using kappa coefficients
