Evidence map›Paper›PMID 37713029›Full record

ArticleInternational journal of clinical pharmacy2023

External validity of an automated delirium prediction model (DEMO) and comparison to the manual VMS-questions: a retrospective cohort study.

Ma Ida Mohmaed Ali, Gerard A Kalkman, Charlotte H W Wijers, Hanneke W H A Fleuren, Cornelis Kramers, Hugo A J M de Wit

Abstract read
PubMed Publisher
In one paragraph

Article in International journal of clinical pharmacy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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.

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, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
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

6 authors.

Ma Ida Mohmaed Ali *Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Gerard A Kalkman *Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. a.kalkman@cwz.nl.ORCID http://orcid.org/0000-0001-7858-7153
Charlotte H W WijersCWZ Academy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Hanneke W H A FleurenDepartment of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Cornelis KramersDepartment of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Hugo A J M de WitDepartment of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is estimated that one-third of delirium cases in hospitals could be prevented with appropriate interventions. In Dutch hospitals a manual instrument (VMS-questions) is used to identify patients at-risk for delirium. Delirium Model (DEMO) is an automated model which could support delirium prevention more efficiently. However, it has not been validated beyond the hospital it was developed in.

aimTo externally validate the DEMO and compare its performance to the VMS-questions.

methodA retrospective cohort study between July and December 2018 was conducted. Delirium cases were identified through a chart review, and the VMS-questions were extracted from the electronic health records. The DEMO was validated in patients ≥ 60 years, and a comparison with the VMS-questions was made in patients ≥ 70 years.

resultsIn total 1,345 admissions were included. The DEMO predicted 59 out of 75 delirium cases (sensitivity 0.79, 95% CI = 0.68-0.87; specificity 0.75, 95% CI = 0.72-0.77). Compared to the VMS-questions, the DEMO showed a lower specificity (0.64 vs. 0.72; p < 0.001) and a comparable sensitivity (0.83 vs. 0.80; p = 0.56). The VMS-questions were missing in 20% of admissions, in which the DEMO correctly predicted 10 of 12 delirium cases.

conclusionThe DEMO showed acceptable performance for delirium prediction. Overall the DEMO predicted more delirium cases because the VMS-questions were missing in 20% of admissions. This study shows that automated instruments such as DEMO could play a key role in the efficient and timely deployment of measures to prevent delirium.

Indexed as

DeliriumHospitalizationHospitalsHumansRetrospective StudiesAutomated modelDeliriumExternal validationHospitalized patientsPrevention measuresRisk prediction

Identifiers

What OpenQuestion holds

Textmetadata
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.