Validity and Reliability Tests of Confusion Assessment Method Algorithms as a Screening Tool for Delirium In Elderly in RSCM Emergency Unit

Background: Delirium is a state of emergency often found with the potential of morbidity and mortality. Elderly people are especially prone to delirium. The prevalence of delirium in the Emergency Unit of Cipto Mangunukusumo Hospital is found to be 0.16% per year, lower than the prevalence of delirium in the geriatric ward (34.4%).  The difference can be caused by many factors, one of which is the difficulties in establishing the diagnosis of delirium. CAM algorithms is an instrument that can be used to increase the identification and recognition of delirium in elderly people.Objective: To get an Indonesian CAM instrument that is valid and reliable to be used as a screening tool for delirium in elderly people in Emergency Unit.Methodology: Research with diagnostic test design was carried out on elderly people who came to the Emergency Unit of RSUPN Dr Ciptomangunkusumo during the period of December 2011 – February 2012.  In validity test, the outlook, content, and criteria are assessed.  From this validity test, sensitivity value, specificity, predicting values and probability ratio are obtained.  In reliability test, Cronbach’s Alpha and Kappa values are obtained to determine the internal and external consistencies of this instrument.  Results. The points of CAM Algorithms Instrument in Indonesian can be understood well by the users and each point is strongly correlated to each other. From 30 samples, Cronbach’s Alpha value of 0.83 and Cronbach’s Kappa value of 0.89 were obtained. From validity test done in 102 samples, sensitivity of 0.90, specificity of 0.99, Negative Predicting Value of 0.98, Positive Predicting Value of 0.95, positive possibility ratio of 75, and negative possibility ratio of 0.10 were obtained.  The duration of this assessment instrument is quite short, about 5.97 minutes (SD 1.97).  Conclusion. CAM Algorithms instrument in Indonesian is valid and reliable to be used as a screening tool for delirium in the elderly people in Emergency Unit. J Indon Med Assoc. 2012;62:264-8.Keywords : Delirium, CAM instrument, diagnostic test