Both authors contributed equally to this manuscript.
Identifying Indicators of Important Diagnostic Features of Delirium
Article first published online: 12 JUN 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 6, pages 1044–1050, June 2012
How to Cite
Huang, L.-W., Inouye, S. K., Jones, R. N., Fong, T. G., Rudolph, J. L., O'Connor, M. G., Metzger, E. D., Crane, P. K. and Marcantonio, E. R. (2012), Identifying Indicators of Important Diagnostic Features of Delirium. Journal of the American Geriatrics Society, 60: 1044–1050. doi: 10.1111/j.1532-5415.2012.03996.x
- Issue published online: 12 JUN 2012
- Article first published online: 12 JUN 2012
- National Institute on Aging (NIA)
- cognitive impairment;
- Confusion Assessment Method;
To use an expert consensus process to identify indicators of delirium features to help enhance bedside recognition of delirium.
Modified Delphi consensus process to assign existing cognitive and delirium assessment items to delirium features in the Confusion Assessment Method (CAM) diagnostic algorithm.
Meetings of expert panel.
Panel of seven interdisciplinary clinical experts.
Panelists' assignments of each assessment item to indicate CAM features.
From an initial pool of 119 assessment items, the panel assigned 66 items to at least one CAM feature, and many items were assigned to more than one feature. Experts achieved a high level of consensus, with a postmeeting kappa for agreement of 0.98. The study staff compiled the assignment results to create a comprehensive list of CAM feature indicators, consisting of 107 patient interview questions, cognitive tasks, and interviewer observations, with some items assigned to multiple features. A subpanel shortened this list to 28 indicators of important delirium features.
A systematic, well-described qualitative methodology was used to create a list of indicators for delirium based on the features of the CAM diagnostic algorithm. This indicator list may be useful as a clinical tool for enhancing delirium recognition at the bedside and for aiding in the development of a brief delirium screening instrument.