| アブストラクト | Delirium is a common neuropsychiatric syndrome that is often overlooked in clinical settings. The most accurate instrument for screening delirium has not been established. This study aimed to compare the diagnostic accuracy of the 4 'A's Test (4AT), Nursing Delirium Screening Scale (Nu-DESC), and Confusion Assessment Method (CAM) in detecting delirium among older adults in clinical settings. These assessment tools feature concise item sets and straightforward administration procedures. Five electronic databases were systematically searched from their inception to September 7, 2022. Studies evaluating the sensitivity and specificity of the 4AT, Nu-DESC, and CAM against the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases as the reference standard were included. Bivariate random effects model was used to summarize the sensitivity and specificity results. A total of 38 studies involving 7378 patients were included. The 4AT, Nu-DESC, and CAM had comparable sensitivity in detecting delirium (0.76, 0.78, and 0.80, respectively). However, the specificity of the CAM was higher than that of the 4AT (0.98 vs 0.89, P = .01) and Nu-DESC 0.99 vs 0.90, P = .003). Diagnostic accuracy was moderated by the percentage of women, acute care setting, sample size, and assessors. The three tools exhibit comparable sensitivity, and the CAM has the highest specificity. Based on the feasibility of the tools, nurses and clinical staffs could employ the Nu-DESC and the 4AT on screening out positive delirium cases and integrate these tools into daily practice. Further investigations are warranted to verify our findings. |
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| 組織名 | School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.;Department of Neurosurgery, School of Medicine, College of Medicine, Taipei;Medical University, Taipei, Taiwan; Division of Neurosurgery, Department of;Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;;Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.;Division of Neurosurgery, Department of Surgery, Shuang Ho Hospital, Taipei;Medical University, New Taipei City, Taiwan; Taipei Neuroscience Institute,;Taipei Medical University, Taipei, Taiwan.;Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung Branch,;Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University,;Taoyuan, Taiwan; Community Medicine Research Center, Chang Gung Memorial;Hospital, Keelung Branch, Keelung, Taiwan.;Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW;2522, Australia; School of Nursing, Faculty of Science, Medicine and Health,;University of Wollongong, Wollongong, Australia.;School of Nursing and Midwifery, Western Sydney University, Parramatta South;Campus, Australia.;School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan;;Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.;Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei;City, Taiwan.;Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan;;Research Center of Sleep Medicine, College of Medicine, Taipei Medical;University, Taipei, Taiwan.;University, Taipei, Taiwan; Department of Nursing, Taipei Medical University;Hospital, Taipei, Taiwan. Electronic address: hychiu0315@tmu.edu.tw. |
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