Evidence map›Paper›PMID 24766743›Full record

ReviewJournal of pain and symptom management2014

Clinical practice guidelines for delirium management: potential application in palliative care.

Shirley H Bush, Eduardo Bruera, Peter G Lawlor, Salmaan Kanji, Daniel H J Davis, Meera Agar, David Kenneth Wright, Michael Hartwick, David C Currow, Bruno Gagnon and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of pain and symptom management, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Article
  4. Article
  5. Review
  6. Article
  7. Neuroleptics in the management of delirium in patients with advanced cancer.Current opinion in supportive and palliative care · 2016
    Review
  8. Forward thinking: where next for delirium prevention research?The Cochrane database of systematic reviews · 2016
    Article
  9. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015
    Article
  10. Review
  11. Delirium diagnosis, screening and management.Current opinion in supportive and palliative care · 2014
    Review
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 4 countries.

Shirley H BushDivision of Palliative Care, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada. Electronic address: sbush@bruyere.org.
Eduardo BrueraThe University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Peter G LawlorDivision of Palliative Care, University of Ottawa, Ottawa, Ontario, Canada; Division of Critical Care, Department of Medicine, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Division of Palliative Care, Department of Medicine, Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Salmaan KanjiThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada.
Daniel H J DavisInstitute of Public Health, University of Cambridge, Cambridge, United Kingdom.
Meera AgarDiscipline, Palliative & Supportive Services, Flinders University, Adelaide, South Australia, Australia; South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia.
David Kenneth WrightMcGill University, Montreal, Québec, Canada.
Michael HartwickDivision of Palliative Care, University of Ottawa, Ottawa, Ontario, Canada; Division of Critical Care, Department of Medicine, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada.
David C CurrowDiscipline, Palliative & Supportive Services, Flinders University, Adelaide, South Australia, Australia.
Bruno GagnonDépartement de médecine familiale et de médecine d'urgence, Université Laval, Québec City, Québec, Canada; Centre de recherche du CHU de Québec, Québec City, Québec, Canada.
Jessica SimonDivision of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine, University of Calgary, Calgary, Alberta, Canada.
José L PereiraDivision of Palliative Care, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada.
University of Ottawa · CAFlinders University · AUBruyère · CAMcGill University · CAOttawa Hospital Research InstituteThe University of Texas MD Anderson Cancer Center · USUniversité Laval · CAUniversity of Calgary · CAUniversity of Cambridge · GB

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Parenteral Hydration in Advanced Cancer Patients: A Randomized Controlled TrialR01CA122292 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2006 to 2009
$2.2M
Methylphenidate for Fatigue in Advanced Cancer PatientsR01NR010162 · NINR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2006 to 2009
$1.3M
Morphine versus Methadone as First Line Strong Opioid for Cancer PainR01CA124481 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2007 to 2009
$1.2M
NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA122292NCI NIH HHS R01 CA124481NINR NIH HHS R01 NR010162Wellcome Trust 090661
6 · The paper itself

Abstract

contextDelirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear.

objectivesThis review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development.

methodsWe searched PubMed (1990-2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting.

resultsThere is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from "expert opinion" for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care.

conclusionDelirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development.

Indexed as

Practice Guidelines as TopicDeliriumHumansPalliative CareDeliriumpalliative carepractice guidelines

Identifiers

PMID24766743
PMCPMC4128754
OpenAlexW2060574824

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.