Evidence map›Paper›PMID 25329203›Full record

ArticleAnnals of internal medicine2014

3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study.

Edward R Marcantonio, Long H Ngo, Margaret O'Connor, Richard N Jones, Paul K Crane, Eran D Metzger, Sharon K Inouye

Erratum issued 3 registry-linked trialsAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 282 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
282citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT03442179 unknown statusnot on this mapstarted 2019, after this paper: background citation

Cognitive Outcomes and Neuroimages Associated With Anesthesia-Related EEG Signatures

TypeobservationalSponsorMassachusetts General HospitalRan2019 to 2024Enrolled24ConditionsElderly, General Anesthesia
NCT05461092 early_phase1recruitingnot on this mapstarted 2024, after this paper: background citation

Regional Nerve Blocks to Improve Analgesia and Recovery in Older Adults Undergoing Spinal Fusion

TypeinterventionalSponsorUniversity of IowaRan2024 to 2026Enrolled50ConditionsDelirium, Pain, Back, Spinal Fusion, Thoracolumbar Interfascial Plane BlockArmsThoracolumbar Interfascial Plane (TLIP) Block of bupivacaine, Blood Test, 3D CAM Delirium Severity Scoring, Generalized Anxiety Disorder 7-item (GAD-7) scale, Numerical Rating Score (NRS)
NCT06626334 naterminatednot on this mapstarted 2024, after this paper: background citation

Blue Light as an Anti-inflammatory and Analgesic Strategy in Thoracic Trauma: A Randomized Controlled Trial in Adults With Rib Fractures

TypeinterventionalSponsorRebecca E Kotcher, MDRan2024 to 2026Enrolled27ConditionsRib Fractures, Pain, AcuteArmsBright Blue Light, Bright Full-Spectrum (White) Light, Usual Ambient Light
3 · Its place in the literature

Who cites it

282 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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222 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Edward R Marcantonio
Long H Ngo
Margaret O'Connor
Richard N Jones
Paul K Crane
Eran D Metzger
Sharon K Inouye

Funding

The Role of Inflammation in the Pathophysiology of Delirium and its Associated Long-Term Cognitive DeclineP01AG031720 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI INOUYE, SHARON K. · 2010 to 2022
$26.7M
READI-SET-GO: Researching Efficient Approaches to Delirium Identification - Sustaining Effective Translation to create Gero-friendly OrganizationsR01AG030618 · NIA · PENNSYLVANIA STATE UNIVERSITY, THE · PI DONNA Marie FICK, EDWARD R MARCANTONIO · 2008 to 2026
$7.9M
Mid-Career Mentoring Award for Patient-Oriented Research in AgingK24AG035075 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R · 2010 to 2021
$1.9M
K07 Leadership GrantK07AG041835 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI INOUYE, SHARON K. · 2013 to 2017
$656k
NIA NIH HHS K07 AG041835NIA NIH HHS K07AG041835NIA NIH HHS K24 AG035075NIA NIH HHS K24AG035075NIA NIH HHS P01 AG031720NIA NIH HHS P01AG031720NIA NIH HHS R01 AG030618NIA NIH HHS R01AG030618
6 · The paper itself

Abstract

backgroundDelirium is common, leads to other adverse outcomes, and is costly. However, it often remains unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would be a substantial advance for clinical care.

objectiveTo derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and validate it against a clinical reference standard.

designDerivation and validation study.

setting4 general medicine units in an academic medical center.

participants201 inpatients aged 75 years or older. MEASUREMENTS: 20 items that best operationalized the 4 CAM diagnostic features were identified to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Clinicians independently did an extensive assessment, including patient and family interviews and medical record reviews. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). The 3D-CAM delirium diagnosis was compared with the reference standard in all patients and subgroups with and without dementia.

resultsThe 201 participants in the prospective validation study had a mean age of 84 years, and 28% had dementia. The expert panel identified 21% with delirium, 88% of whom had hypoactive or normal psychomotor features. Median administration time for the 3D-CAM was 3 minutes (interquartile range, 2 to 5 minutes), sensitivity was 95% (95% CI, 84% to 99%), and specificity was 94% (CI, 90% to 97%). The 3D-CAM did well in patients with dementia (sensitivity, 96% [CI, 82% to 100%]; specificity, 86% [CI, 67% to 96%]) and without dementia (sensitivity, 93% [CI, 66% to 100%]; specificity, 96% [CI, 91% to 99%]). LIMITATION: Limited to single-center, cross-sectional, and medical patients only.

conclusionThe 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PRIMARY FUNDING SOURCE: National Institute on Aging.

Indexed as

Neuropsychological TestsAgedAged, 80 and overAlgorithmsConfusionCross-Sectional StudiesDeliriumFemaleHospitalizationHumansInterviews as TopicMaleReproducibility of ResultsSensitivity and Specificity

Identifiers

PMID25329203
PMCPMC4319978

What OpenQuestion holds

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Registered trials

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.