Observational studyThe American journal of emergency medicine2025
Validation of a chart review method for identifying delirium in the emergency department.
Observational study in The American journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectiveTo validate the Chart-based Delirium Identification Instrument (CHART-DEL) which was developed in the inpatient setting, for identifying delirium in the emergency department (ED).
methodsThis retrospective observational study included ED patients aged 75 and older who presented between 2021 and 2023 and were screened for delirium utilizing a validated two-step tool which included the Delirium Triage Screen (DTS) and the Brief Confusion Assessment Method (bCAM). A stratified random sample of 600 medical records were reviewed using the CHART-DEL method. Inter-rater agreement and diagnostic test accuracy were calculated. We followed standardized guidelines for reporting (STROBE).
resultsA total of 27,082 visits were included. Median age was 83 years, 51.8 % were women. Twenty percent of patients had known dementia and/or cognitive impairment, and 48.8 % were admitted to the hospital. There were 1197 patients (4.4 %) with delirium in the ED. When compared to the ED assessment, the chart review correctly identified 474/600 cases (accuracy 79.0 %, 95 % CI: 75.5-82.1 %), including 223/300 with delirium (sensitivity 74.3 %, 95 % CI: 68.9-79.1 %), and 251/300 without delirium (specificity 83.7 %, 95 % CI: 78.9-87.6 %). Agreement between the reviewers was 91.0 %. Weight calculations to approximate the original population resulted in an accuracy of 86.4 % (95 % CI: 86.0-86.8 %), sensitivity of 74.2 % (95 % CI: 71.6-76.6 %) and specificity of 87.0 % (95 % CI: 86.6-87.4 %).
conclusionThe CHART-DEL can be applied to the ED setting, but performed better at correctly identifying patients who do not have delirium. Automating this method could improve retrospective delirium detection in the ED and support future clinical applications of delirium screening tools.
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