Evidence map›Paper›PMID 30887938›Full record

Observational studyPalliative & supportive care2019

Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study.

Jo Ellen Wilson, Leanne Boehm, Lauren R Samuels, Deborah Unger, Martha Leonard, Christianne Roumie, E Wesley Ely, Robert S Dittus, Sumi Misra, Jin H Han

Abstract readObservational Study
In one paragraph

Observational study in Palliative & supportive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. 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

10 authors at 3 institutions in 1 country.

Jo Ellen WilsonGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
Leanne BoehmGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.ORCID 0000-0003-0127-6677
Lauren R SamuelsGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.ORCID 0000-0002-7273-5626
Deborah UngerDepartment of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center.
Martha LeonardDepartment of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center.
Christianne RoumieGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
E Wesley ElyGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
Robert S DittusGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
Sumi MisraGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
Jin H HanGeriatric Research, Education and Clinical Center, Veterans Affairs TN Valley.
Geriatric Research Education and Clinical Center · USVeterans Health Administration · USVanderbilt University · US

Funding

Institutional Career Development CoreKL2TR002245 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Julie A. Bastarache · 2017 to 2026
$9.3M
The MIND USA StudyR01AG035117 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY · 2011 to 2016
$7.3M
Altering Sedation Paradigms to Improve Brain Injury and Survival in Severe SepsisR01HL111111 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PANDHARIPANDE, PRATIK · 2012 to 2017
$3.7M
The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU StudyR01GM120484 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PATEL, MAYUR B · 2017 to 2021
$3.0M
Vanderbilt Scholars in T4 Translational Research (V-STTaR) ProgramK12HL137943 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KRIPALANI, SUNIL, ROUMIE, CHRISTIANNE L. · 2017 to 2021
$2.9M
NCATS NIH HHS KL2 TR002245NHLBI NIH HHS K12 HL137943NHLBI NIH HHS R01 HL111111NIA NIH HHS R01 AG035117NIGMS NIH HHS R01 GM120484
6 · The paper itself

Abstract

objectiveMany patients with advanced serious illness or at the end of life experience delirium, a potentially reversible form of acute brain dysfunction, which may impair ability to participate in medical decision-making and to engage with their loved ones. Screening for delirium provides an opportunity to address modifiable causes. Unfortunately, delirium remains underrecognized. The main objective of this pilot was to validate the brief Confusion Assessment Method (bCAM), a two-minute delirium-screening tool, in a veteran palliative care sample.

methodThis was a pilot prospective, observational study that included hospitalized patients evaluated by the palliative care service at a single Veterans' Administration Medical Center. The bCAM was compared against the reference standard, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Both assessments were blinded and conducted within 30 minutes of each other.

resultWe enrolled 36 patients who were a median of 67 years (interquartile range 63-73). The primary reasons for admission to the hospital were sepsis or severe infection (33%), severe cardiac disease (including heart failure, cardiogenic shock, and myocardial infarction) (17%), or gastrointestinal/liver disease (17%). The bCAM performed well against the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, for detecting delirium, with a sensitivity (95% confidence interval) of 0.80 (0.4, 0.96) and specificity of 0.87 (0.67, 0.96). SIGNIFICANCE OF

resultsDelirium was present in 27% of patients enrolled and never recognized by the palliative care service in routine clinical care. The bCAM provided good sensitivity and specificity in a pilot of palliative care patients, providing a method for nonpsychiatrically trained personnel to detect delirium.

Indexed as

AgedConfusionFemaleHumansMaleMass ScreeningMiddle AgedNeuropsychological TestsPalliative CarePilot ProjectsProspective StudiesUnited StatesUnited States Department of Veterans AffairsValidation Studies as TopicVeteranscognitiondeliriumend-of-lifepalliative carescreening

Identifiers

PMID30887938
PMCPMC6752980
OpenAlexW2924336459

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.