ArticleJournal of neurology, neurosurgery, and psychiatry2014
Attention! A good bedside test for delirium?
Article in Journal of neurology, neurosurgery, and psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Delirium detection methodologies: Implications for outcome measurement in clinical trials in postoperative delirium.International journal of geriatric psychiatry · 2022Trial
- A multicentre, pragmatic, cluster randomised, controlled feasibility trial of the POD system of care.Age and ageing · 2020Trial
- Use of the confusion assessment method in multicentre delirium trials: training and standardisation.BMC geriatrics · 2019Trial
- Trial
- Delirium and cognitive assessment in national hip fracture registries: a scoping review.European geriatric medicine · 2025Article
- Impact of Living Arrangements on Delirium in Older ED Patients.Journal of clinical medicine · 2025Article
- Current Trends for Delirium Screening within the Emergency Department.Medicina (Kaunas, Lithuania) · 2023Review
- Detecting delirium: a systematic review of ultrabrief identification instruments for hospital patients.Frontiers in psychology · 2023Review
- Comparison of delirium detection tools in acute care : A rapid review.Zeitschrift fur Gerontologie und Geriatrie · 2022Review
- Comparing performance on the Months of the Year Backwards test in hospitalised patients with delirium, dementia, and no cognitive impairment: an exploratory study.European geriatric medicine · 2021Article
- Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting.BMC geriatrics · 2021Article
- Development of the AL-O-A Score for Delirium Screening in Acute Internal Medicine: a Monocentric Prospective Study.Journal of general internal medicine · 2021Article
- Approach to Cognitive Impairment in Parkinson's Disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Comparison of novel tools with traditional cognitive tests in detecting delirium in elderly medical patients.World journal of psychiatry · 2020Article
- Ultra-brief Screeners for Detecting Delirium Superimposed on Dementia.Journal of the American Medical Directors Association · 2019Article
- Selecting a Bedside Cognitive Vital Sign to Monitor Cognition in Hospital: Feasibility, Reliability, and Responsiveness of Logical Memory.International journal of environmental research and public health · 2019Article
- Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients.Journal of general internal medicine · 2019Article
- Delirium Assessment in Older People in Emergency Departments. A Literature Review.Diseases (Basel, Switzerland) · 2019Review
- Autonomic cardiovascular control in older patients with acute infection and delirium: a pilot study of orthostatic stress responses.BMC geriatrics · 2019Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRoutine 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'.
methodsWe 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.
results265 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 (cut-off 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.
conclusionsOur results suggest that simple attention tests may be useful in delirium screening. MOTYB used alone was the most accurate screening test in older people.
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