Author, as appears in the article.: Sepulveda, Esteban; Bermudez, Ester; Gonzalez, Dulce; Cotino, Paula; Vinuelas, Eva; Palma, Jose; Ciutat, Marta; Grau, Imma; Vilella, Elisabet; Trzepacz, Paula T; Franco, Jose G
Department: Medicina i Cirurgia
URV's Author/s: Bermúdez Gómez, Ester / FRANCO VÁSQUEZ, JOSÉ GABRIEL / González Ruiz, Dora Alejandra / GRAU JOAQUIN, INMACULADA CONCEPCIÓN / Sepulveda Ramos, Esteban / Vilella Cuadrada, Elisabet
Keywords: Validation process Skilled nursing. Skilled nursing facilities Sensitivity and specificity Psychiatrist Psychiatric status rating scales. Prospective study Prospective studies Predictive value Nursing home Mental disease assessment Male Major clinical study Intermethod comparison Humans Human Geriatrician Geriatric assessment. Geriatric assessment Female Dsm-5 Disease severity Diagnostic tests comparison. Diagnostic test accuracy study Diagnostic accuracy Dementia Delirium diagnostic tool Delirium diagnosis Delirium Ddt Cross-sectional study Cross-sectional studies Controlled study Article Aged Adult 4 a test
Abstract: Objective: To validate the Delirium Diagnostic Tool (DDT-Pro) in a SNF and compare its performance to the 4 A's Test (4AT) in real life conditions. Methods: Prospective cross-sectional study of 262 consecutively admitted adults to a SNF, independently assessed by psychiatrists using DSM-5 delirium criteria and by geriatricians using the DDT-Pro (0–9 points) and 4AT (0–12 points). Results: 141 (53.8%) participants had dementia and 79 (30.1%) had delirium. DDT-Pro and 4AT were moderately correlated (?0.59). Accuracies against DSM-5 diagnosis ranged from 80 to 85% and were comparable between tools regardless of dementia. Recommended delirium cutoff for the DDT-Pro (?6) had 77.2% sensitivity, 84% specificity, and NPV = 89.5% and 4AT (?4) had 54.4% sensitivity and 92.9% specificity, with lower specificity in the dementia subsample. DDT-Pro sensitivity increased (84.8%) at ?7cutoff. Sensitivity and specificity of all DDT-Pro and 2/4 4AT items displayed gradients along severity levels, but two dichotomously rated 4AT items had low positivity. The tools had low concordance (p < 0.05) for delirium positivity. Conclusions: DDT-Pro is valid to detect delirium in SNF population where simple, structured tools with high sensitivity are needed. DDT-Pro items assess the three core domains of delirium as a continuous measure and may have advantages over the 4AT. © 2021 Elsevier Inc.
Thematic Areas: Saúde coletiva Psychiatry and mental health Psychiatry Psicología Medicina ii Medicina i Matemática / probabilidade e estatística Interdisciplinar Farmacia Ensino Enfermagem Direito Ciencias sociales Ciências biológicas ii Ciências biológicas i
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: esteban.sepulveda@urv.cat ester.bermudez@urv.cat elisabet.vilella@urv.cat doraalejandra.gonzalez@estudiants.urv.cat ester.bermudez@urv.cat
Author identifier: 0000-0002-1887-5919
Record's date: 2024-10-12
Papper version: info:eu-repo/semantics/acceptedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: General Hospital Psychiatry. 70 116-123
APA: Sepulveda, Esteban; Bermudez, Ester; Gonzalez, Dulce; Cotino, Paula; Vinuelas, Eva; Palma, Jose; Ciutat, Marta; Grau, Imma; Vilella, Elisabet; Trzepac (2021). Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 ‘A's test (4AT). General Hospital Psychiatry, 70(), 116-123. DOI: 10.1016/j.genhosppsych.2021.03.010
Entity: Universitat Rovira i Virgili
Journal publication year: 2021
Publication Type: Journal Publications
Repositori URV