Table 2.
Criterion validity of delirium detection tools (paired assessments) compared to the reference standard assessment (n = 628)
| Delirium Prevalence % (95% CI) | Sensitivity % (95% CI) | Specificity % (95% CI) | AUC % (95% CI) | AUC P‐value | |
|---|---|---|---|---|---|
| Reference standard | |||||
| DSM‐5 | 34.2 (30.6–38.0) | — | — | — | — |
| Routine screening | |||||
| ICDSC | 24.3 (21.2–27.9) | 58.1 (51.2–64.8) | 93.2 (90.4–95.4) | 75.7 (72.1–79.2) | |
| CAM‐ICU | 33.4 (29.8–37.2) | 68.8 (62.2–75.0) | 85.0 (81.2–88.3) | 76.9 (73.4–80.5) | |
| Chart‐based (cut point) | |||||
| CHART‐DEL‐ICU (def/prob) | 22.9 (19.8–26.4) | 45.1 (38.3–52.0) | 88.6 (85.2–91.5) | 66.9 (63.2–70.5) | — |
| CHART‐DEL‐ICU (def/prob/poss) | 25.4 (22.2–29.0) | 50.7 (43.8–57.6) | 87.7 (84.1–90.7) | 69.1 (65.5–72.9) | — |
| CHART‐DEL‐ICU (def/prob/poss/unc) | 34.4 (30.8–38.2) | 66.0 (59.3–72.3) | 82.1 (78.0–85.7) | 74.1 (70.4–77.8) | — |
| Chart based + routine screening (cut point) | |||||
| CHART‐DEL‐ICU + CAM‐ICU (def/prob) | 42.5 (38.7–46.4) | 80.9 (75.0–86.0) | 77.5 (73.1–81.4) | 79.2 (75.9–82.5) |
(vs CHART‐DEL‐ICU) <0.001 |
| CHART‐DEL‐ICU + CAM‐ICU (def/prob/poss) | 43.9 (40.1–47.9) | 83.3 (77.6–88.0) | 76.5 (72.1–80.5) | 79.9 (76.7–83.1) |
(vs CHART‐DEL‐ICU) <0.001 |
| CHART‐DEL‐ICU + CAM‐ICU (def/prob/poss/unc) | 48.2 (44.3–52.2) | 88.8 (83.8–92.7) | 72.9 (68.3–77.1) | 80.9 (77.8–83.9) |
(vs CHART‐DEL‐ICU) <0.001 |
| CHART‐DEL‐ICU + ICDSC (def/prob) | 34.9 (31.2–38.7) | 71.2 (64.6–77.1) | 84.0 (80.1–87.4) | 77.6 (74.1–81.1) |
(vs CHART‐DEL‐ICU) <0.001 |
| CHART‐DEL‐ICU + ICDSC (def/prob/poss) | 35.5 (31.9–39.3) | 72.1 (65.6–78.0) | 83.5 (79.6–87.0) | 77.8 (74.3–81.3) |
(vs CHART‐DEL‐ICU) <0.001 |
| CHART‐DEL‐ICU + ICDSC (def/prob/poss/unc) | 41.1 (37.3–45.0) | 79.5 (73.5–84.7) | 78.9 (74.7–82.8) | 79.2 (75.9–82.6) |
(vs CHART‐DEL‐ICU) <0.001 |
Abbreviations: AUC, area under the receiver operating characteristic curve, CAM‐ICU, Confusion Assessment Method for the ICU; CHART‐DEL‐ICU, Chart‐based Delirium Screening for the ICU; def, definite; ICDSC, Intensive Care Delirium Screening Checklist; poss, possible; prob, probable; unc, uncertain.