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Table 3 Patients’ clinical diagnosis and simple orientation questions

From: The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists

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
  1. 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
  2. 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
  3. bAnalysis was performed among the 78 patients (72%) who were able to answer all three simple questions
  4. 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
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