Table 3.
Delirium detection tools emerged from the included studies: comparison in the diagnostic test accuracy properties documented
| Tool | Author, year [reference] | Sensitivity % (95% CI) | Specificity % (95% CI) | Positive predictive value % (95% CI) | Negative predictive value % (95% CI) | Internal consistency (Cronbach α) | Accuracy % (95% CI) | Interrater reliability (Ƙ) | Likelihood ratio | AUC | Gold standard considered |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4AT | Infante et al., 2017 [20] | 90.2b | 64.5b | 0.82a | DSM-V criteria | ||||||
| 96.4c | 76.7c | 0.88b | |||||||||
| Kutlubaev et al., 2016 [21] | 93 | 86 | 86 | 85.6 | 0.80 | 0.89 | DSM-IV criteria | ||||
| Lees et al., 2013 [22] |
100 (74–100) |
82 (72–89) |
43 | 100 | CAM | ||||||
|
100a (72–100) |
83a (73–88) |
CAM | |||||||||
| CAM-ICU | Mitasova et al., 2012 [8] |
76 (55–91) |
98 (93–100) |
91 (70–99) |
94 (88–98) |
94d (88–97) |
0.94 (0.83–1.00) |
0.47 (0.27–0.83) |
DSM-IV criteria | ||
| AMT-10 | Lees et al., 2013 [22] |
75 (43–95) |
61 (51–71) |
21 | 95 | CAM | |||||
| AMT-4 | Lees et al., 2013 [22] |
83 (52–98) |
61 (51–71) |
23 | 96 | CAM | |||||
| CDT | Lees et al., 2013 [22] |
67 (22–96) |
38 (28–49) |
7 | 95 | CAM | |||||
| COG4 | Lees et al., 2013 [22] |
70 (35–93) |
44 (35–55) |
13 | 92 | CAM | |||||
| GCS | Lees et al., 2013 [22] |
17 (2–48) |
81 (71–88) |
11 | 88 | CAM | |||||
| “Does this patient has cognitive issues?“e | Lees et al., 2013 [22] |
58 (28–85) |
85 (76–92) |
35 | 93 | CAM |
asubgroup analysis, excluding patients with severe aphasia (n = 7; over 111 patients included); bat the admission; cafter 7 days; dconsidered as ratio: true-positives + true-negatives/true positives + false-positives + true-negatives + false-negatives; ethe single question was asked to healthcare professionals of the multidisciplinary team
4AT: 4-Assessment Test for delirium, AMT: Abbreviated Mental Test, AUC Area Under the Curve, CAM: Confusion Assessment Method, CAM-ICU: Confusion Assessment Method for the Intensive Care Unit, CDT: Clock Drawing Test, CI: Confidence of Interval, COG4: cognitive examination derived from National Institutes of Health Stroke Scale (NIHSS), DSM: Diagnostic and Statistical Manual of mental disorders, GCS: Glasgow Coma Scale.