ArticleJournal of the American Geriatrics Society2021
Adaptation and Validation of a Chart-Based Delirium Detection Tool for the ICU (CHART-DEL-ICU).
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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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
26 citing papers in PubMed, 42 citations in OpenAlex.
- Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial.Critical care (London, England) · 2026Trial
- Observational
- Blood-based biomarkers and delirium in critically ill adults in the ICU: a systematic review.Intensive care medicine experimental · 2026Review
- Costs associated with delirium among older patients undergoing complex spine surgeries.Journal of neurosurgery. Spine · 2026Observational
- Efficacy of large language models in detecting postoperative delirium from unstructured clinical notes: A retrospective cohort study.NPJ digital medicine · 2025Article
- Optimizing Agreement Between Bedside Nurse-Documented and Trained Researcher Delirium Assessments in the ICU.Critical care medicine · 2025Article
- Advancing delirium detection through the Open Health Natural Language Processing Consortium and the Evolve to Next-Gen Accrual to Clinical Trials Network.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- New developments on the effects of alcohol use on immunity, inflammation and organ function: A summary of the 2024 Alcohol and Immunology Research Interest Group (AIRIG) meeting.Alcohol (Fayetteville, N.Y.) · 2025Article
- Symptom trajectories after COVID hospitalization and risk factors for symptom burden in older persons: a longitudinal cohort study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Functional Trajectories After COVID-19 Hospitalization Among Older Adults.Journal of the American Geriatrics Society · 2025Article
- Post-Discharge COVID-19 Symptoms Predict 1-Year Functional Decline, Falls, and Emergency Department Visits: A Cohort Study.Journal of the American Geriatrics Society · 2025Article
- Association of Central Nervous System-Related Biomarkers With Hospital Delirium in Patients With Respiratory Failure in the ICU.CHEST critical care · 2025Article
- Cross-cultural validation of the Chart-based Delirium Identification Instrument: Using a chart-based method to identify delirium in hospitalized older adults.Geriatrics & gerontology international · 2025Article
- Neuron-specific enolase and Tau protein as biomarkers for sepsis-associated delirium: a cross-sectional pilot study.Einstein (Sao Paulo, Brazil) · 2025Article
- Feasibility of In-Hospital Administration of a Tool to Predict Persistent Post-ICU Functional Impairment Among Older ICU Survivors: A Pilot Study.CHEST critical care · 2024Article
- Effect of a Three-Component Geriatrics Bundle on Incident Delirium among Critically Ill Older Adults: A Pilot Clinical Trial.Annals of the American Thoracic Society · 2024Article
- In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization.JAMA network open · 2024Article
- A Perioperative Mental Health Intervention for Depressed and Anxious Older Surgical Patients: Results From a Feasibility Study.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024Article
- Characterizing medical patients with delirium: A cohort study comparing ICD-10 codes and a validated chart review method.PloS one · 2024Article
- The impact of preoperative frailty on perioperative neurocognitive disorders in elderly patients: A systematic review and meta-analysis.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2024Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveTo adapt and validate a chart-based delirium detection tool for use in critically ill adults.
designValidation study.
settingMedical-surgical intensive care unit (ICU) in an academic hospital. MEASUREMENTS: A chart-based delirium detection tool (CHART-DEL) was adapted for use in critically ill adults (CHART-DEL-ICU) and compared with prospective delirium assessments (i.e., clinical assessments (reference standard) by a research nurse trained by a neuropsychiatrist and routine delirium screening tools Confusion Assessment Method (CAM-ICU)) and (Intensive Care Delirium Screening Checklist (ICDSC)). The original CHART-DEL tool was adapted to include physician-reported ICDSC score (for probable delirium) and Richmond-Agitation Sedation Scale score (for altered level of consciousness and agitation). Two trained chart abstractors blinded to all delirium assessments manually abstracted delirium-related information from medical charts and electronic medical records and rated if delirium was present (four levels: uncertain, possible, probable, definite) or absent (no evidence).
resultsCharts were manually abstracted for delirium-related information for 213 patients who were included in a prospective cohort study that included prospective delirium assessments. The CHART-DEL-ICU tool had excellent interrater reliability (kappa = 0.90). Compared to the reference standard, the sensitivity was 66.0% (95% CI = 59.3-72.3%) and specificity was 82.1% (95% CI = 78.0-85.7%), with a cut-point that included definite, probable, possible, and uncertain delirium. The AUC of the CHART-DEL-ICU alone is 74.1% (95% CI = 70.4-77.8%) compared with the addition of the CAM-ICU and ICDSC (CAM-ICU/CHART-DEL-ICU: 80.9% (95% CI = 77.8-83.9%), P = .01; ICDSC/CHART-DEL-ICU: 79.2% (95% CI = 75.9-82.6%), P = .03).
conclusionA chart-based delirium detection tool has improved diagnostic accuracy when combined with routine delirium screening tools (CAM-ICU and ICDSC), compared to a chart-based method on its own. This presents a potential for retrospective detection of delirium from medical charts for research or to augment routine delirium screening methods to find missed cases of delirium.
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