Table 3.
Validation and reliability studies of confusion assessment method for the Intensive Care Unit and Intensive Care Delirium Screening Checklist
| Study | Scoring Method | Delirium prevalence (%) | Study design | Study population | Comparator | Sensitivity (%) | Specificity (%) | Interrater reliability (kappa statistic) |
|---|---|---|---|---|---|---|---|---|
| Ely et al.[49] | CAM-ICU | 87 | Prospective, cohort study, single-center | 38 medical and coronary ICU patients (58% mechanical ventilation), 293 assessments | Intensivist and 2 intensive care nurses using the CAM-ICU versus delirium expert using criteria from the DSM IV | Intensivist - 100 Nurse 1 - 95 Nurse 2 - 96 |
Intensivist - 89 Nurse 1 - 93 Nurse 2 - 93 |
0.81-0.95 |
| Ely et al.[50] | CAM-ICU | 39 | Prospective, cohort study, single-center | 96 medical and coronary ICU patients (100% mechanical ventilation), 471 paired daily assessments | 2 intensive care nurses using the CAM-ICU versus delirium expert using criteria from the DSM IV | Nurse 1 - 100 Nurse 2 - 93 |
Nurse 1 - 98 Nurse 2 - 100 |
0.96 |
| Lin et al.[51] | CAM-ICU | 22 | Prospective, cohort study, single-center | 111 medical and coronary ICU patients (100% mechanical ventilation), 204 paired daily assessments | 2 research assistants using the CAM-ICU versus delirium expert using criteria from the DSM IV | Assessor 1 - 91 Assessor 2 - 95 | Assessor 1 - 98 Assessor 2 - 98 | 0.91 |
| McNicoll et al.[52] | CAM-ICU | 50 | Prospective, cohort study, single-center | 22 elderly medical ICU patients (0% mechanical ventilation), 22 paired assessments | One clinician researcher using the CAM-ICU and one using CAM | 73 | 100 | 0.64 |
| Pun et al.[53] | CAM-ICU | Prospective, cohort study, multicenter | 711 medical ICU patients | Bedside nurse versus Reference standard rater | N/A | N/A | 0.75 at community hospital, 0.92 at academic hospital | |
| Van Eijk et al.[54] | CAM-ICU | 41 | Prospective, multicenter | 181 mixed medical and surgical ICU patients | ICU nurse using CAM-ICU versus delirium expert using criteria from the DSM IV | 47 | 98 | N/A |
| Luetz et al.[55] | CAM-ICU | 40 | Prospective, cohort study, single-center | 156 surgical ICU patients | Trained staff members using CAM-ICU versus delirium expert using criteria from the DSM IV | 81 | 96 | 0.89 |
| van Eijk et al.[48] | CAM-ICU and ICDSC | 34 | Prospective, single-center | 125 mixed medical and surgical ICU patients | ICU nurse using either CAM-ICU or ICDSC versus delirium expert using criteria from the DSM IV | CAM-ICU - 64 ICDSC - 43 | CAM-ICU - 88 ICDSC - 95 | N/A |
| Bergeron et al.[56] | ICDSC | 16 | Prospective, cohort study, single-center | 93 mixed medical and surgical ICU patients (mechanical ventilation not reported) | Intensivist and 2 nurses using the ICDSC versus delirium expert using ICDSC | 99 | 64 | 0.94 |
| George et al.[57] | ICDSC | 34 | Prospective, cohort study, single-center | 59 medical ICU patients (0% mechanical ventilation) | Trained residents using the ICDSC versus delirium expert using the International Classification of Diseases, 10th Revision diagnostic criteria | 90 | 61 | 0.947 |
DSM IV: Diagnostic and Statistical Manual of Mental Disorders, 4th edition, CAM-ICU: Confusion assessment method for the ICU, ICDSC: Intensive Care Delirium Screening Checklist, ICU: Intensive Care Unit, N/A: Not available