Table 4.
Delirium-Identification Algorithms in Administrative Claims and Drug Utilization Database in the Literature
| Algorithms (Reference standard) | Population (N delirium / N total) | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) |
|---|---|---|---|---|---|
| Johnson 199212 14 ICD-9 diagnosis codesa (DSM III) |
Medical (47/235) | 0.09 (0.02, 0.20) | NR | NR | NR |
| Inouye 200511 8 ICD-9 diagnosis codesb (CAM) |
Medical (115/919) | 0.03 (0.01, 0.07) | 0.99 (0.99, 1.00) | 0.38 (0.09, 0.76) | 0.88 (0.85, 0.90) |
| Katznelson 201013 ICD-10 diagnosis codesc (CAM-ICU) |
Cardiac surgery (182/1528) | 0.18 (0.13, 0.25) | 0.99 (0.98, 1.00) | 0.72 (0.56, 0.84) | 0.90 (0.88, 0.91) |
| Campbell 201415 ICD-9 diagnosis codesc (CAM) |
Medical (163/424) | 0.32 (0.25, 0.40) | 0.85 (0.80, 0.89) | 0.57 (0.46, 0.67) | 0.67 (0.61, 0.72) |
| Hope 201410 8 ICD-9 diagnosis codesd (expert consensus) |
Medical, surgical, ICU (25/NR) | 0.28 (0.12, 0.49) | NR | NR | NR |
| Bui 201614 32 ICD-9 diagnosis codese (CAM-ICU) |
Surgical ICU (423/1055) | 0.36 (0.31, 0.40) | 0.95 (0.93, 0.97) | 0.83 (0.76, 0.88) | 0.69 (0.66, 0.72) |
| Rothberg 201318 Use of any of 4 APMsf (medical record) |
Medical (NR) | NR | NR | 0.55 (0.39, 0.70) | NR |
| Loh 201417 Use of any of 5 APMsg (medical record) |
Medical, surgical, ICU (NR) | NR | NR | 0.83 (0.78, 0.87) | NR |
| Herzig 201626 Use of any of 20 APMsh (medical record) |
Medical, surgical, ICU (NR) | NR | NR | 0.65 (0.55, 0.74) | NR |
Abbreviations: APM, antipsychotic medications; CAM, Confusion Assessment Method; CI, confidence interval; DSM, Diagnostic and Statistical Manual of Mental Disorders; ICD, International Classification of Diseases; ICU, intensive care unit; NPV, negative predictive value; NR, not reported; PPV, positive predictive value.
ICD-9 diagnosis codes include 290.11, 290.3, 290.41, 291.0, 292.0, 292.1, 292.12, 292.2, 292.81, 292.9, 293.0, 293.1, 293.9, and 780.0.
ICD-9 diagnosis codes include 290.11, 290.3, 290.41, 291.0, 292.81, 293.0, 293.1, and 780.09.
ICD diagnosis codes were not specified.
ICD-9 diagnosis codes include 290.3, 291, 291.1, 292, 292.81, 293, 293.1, and 780.09.
ICD-9 diagnosis codes include 290.11–290.13, 290.20, 290.3, 290.41–290.43, 290.8, 290.9, 291.0, 292.0–292.2, 292.81, 292.82, 293.0–293.9, 348.30, 348.31, 348.39, 349.82, 780.02, 780.09, and 780.97.
Antipsychotic medications included aripiprazole, haloperidol, risperidone, and ziprasidone, and excluded olanzapine.
Antipsychotic medications included haloperidol, thorazine, olanzapine, quetiapine, and risperidone.
Antipsychotic medications included aripiprazole, asenapine, chlorpromazine, clozapine, fluphenazine, haloperidol, iloperidone, loxapine, lurasidone, molindone, olanzapine, paliperidone, perphenazine, pimozide, quetiapine, risperidone, thioridazine, thiothixene, trifluoperazine, and ziprasidone.