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Identifying Indicators of Important Diagnostic Features of Delirium
Author(s) -
Huang LiWen,
Inouye Sharon K.,
Jones Richard N.,
Fong Tamara G.,
Rudolph James L.,
O'Connor Margaret G.,
Metzger Eran D.,
Crane Paul K.,
Marcantonio Edward R.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.03996.x
Subject(s) - delirium , medicine , feature (linguistics) , cognition , interview , process (computing) , artificial intelligence , computer science , psychiatry , philosophy , linguistics , political science , law , operating system
Objectives To use an expert consensus process to identify indicators of delirium features to help enhance bedside recognition of delirium. Design Modified D elphi consensus process to assign existing cognitive and delirium assessment items to delirium features in the C onfusion A ssessment M ethod ( CAM ) diagnostic algorithm. Setting Meetings of expert panel. Participants Panel of seven interdisciplinary clinical experts. Measurements Panelists' assignments of each assessment item to indicate CAM features. Results From an initial pool of 119 assessment items, the panel assigned 66 items to at least one CAM feature, and many items were assigned to more than one feature. Experts achieved a high level of consensus, with a postmeeting kappa for agreement of 0.98. The study staff compiled the assignment results to create a comprehensive list of CAM feature indicators, consisting of 107 patient interview questions, cognitive tasks, and interviewer observations, with some items assigned to multiple features. A subpanel shortened this list to 28 indicators of important delirium features. Conclusion A systematic, well‐described qualitative methodology was used to create a list of indicators for delirium based on the features of the CAM diagnostic algorithm. This indicator list may be useful as a clinical tool for enhancing delirium recognition at the bedside and for aiding in the development of a brief delirium screening instrument.