3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium

谵妄 医学 痴呆 四分位间距 前瞻性队列研究 老年病科 病历 金标准(测试) 重症监护医学 内科学 精神科 疾病
作者
Edward R. Marcantonio,Long Ngo,Margaret O’Connor,Richard N. Jones,Paul K. Crane,Eran D. Metzger,Sharon K. Inouye
出处
期刊:Annals of Internal Medicine [American College of Physicians]
卷期号:161 (8): 554-554 被引量:409
标识
DOI:10.7326/m14-0865
摘要

This article has been corrected. The original version (PDF) is appended to this article as a Supplement. Background: Delirium is common, leads to other adverse outcomes, and is costly. However, it often remains unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would be a substantial advance for clinical care. Objective: To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and validate it against a clinical reference standard. Design: Derivation and validation study. Setting: 4 general medicine units in an academic medical center. Participants: 201 inpatients aged 75 years or older. Measurements: 20 items that best operationalized the 4 CAM diagnostic features were identified to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Clinicians independently did an extensive assessment, including patient and family interviews and medical record reviews. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). The 3D-CAM delirium diagnosis was compared with the reference standard in all patients and subgroups with and without dementia. Results: The 201 participants in the prospective validation study had a mean age of 84 years, and 28% had dementia. The expert panel identified 21% with delirium, 88% of whom had hypoactive or normal psychomotor features. Median administration time for the 3D-CAM was 3 minutes (interquartile range, 2 to 5 minutes), sensitivity was 95% (95% CI, 84% to 99%), and specificity was 94% (CI, 90% to 97%). The 3D-CAM did well in patients with dementia (sensitivity, 96% [CI, 82% to 100%]; specificity, 86% [CI, 67% to 96%]) and without dementia (sensitivity, 93% [CI, 66% to 100%]; specificity, 96% [CI, 91% to 99%]). Limitation: Limited to single-center, cross-sectional, and medical patients only. Conclusion: The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. Primary Funding Source: National Institute on Aging.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
Postgraduate-Z完成签到,获得积分10
1秒前
哈基米德应助热情的老虎采纳,获得20
1秒前
1秒前
2秒前
2秒前
2秒前
Xuhhh完成签到,获得积分20
2秒前
小圭发布了新的文献求助10
3秒前
Zhao完成签到 ,获得积分10
3秒前
ruhemann发布了新的文献求助10
3秒前
3秒前
SGQT完成签到,获得积分10
4秒前
4秒前
LWX完成签到,获得积分10
5秒前
脆皮玉米完成签到,获得积分10
5秒前
隐形曼青应助苏苏采纳,获得10
5秒前
6秒前
Xuhhh发布了新的文献求助10
7秒前
wendinfgmei发布了新的文献求助10
7秒前
7秒前
学术laji发布了新的文献求助10
7秒前
陳钧浩完成签到,获得积分10
7秒前
天天快乐应助Rgly采纳,获得10
8秒前
8秒前
CodeCraft应助mhq采纳,获得10
8秒前
现代听枫完成签到,获得积分10
8秒前
8秒前
9秒前
9秒前
9秒前
9秒前
摆烂昊发布了新的文献求助10
9秒前
留胡子的寄瑶完成签到 ,获得积分10
10秒前
10秒前
10秒前
10秒前
Jenny应助超甜大西瓜采纳,获得10
10秒前
你好发布了新的文献求助10
10秒前
Ran完成签到,获得积分20
11秒前
高分求助中
【请各位用户详细阅读此贴后再求助】科研通的精品贴汇总(请勿应助) 10000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
求 5G-Advanced NTN空天地一体化技术 pdf版 500
Cardiovascular Disease Genetic Risk Prediction Models: A Systematic Review 500
International Code of Nomenclature for algae, fungi, and plants (Madrid Code) (Regnum Vegetabile) 500
Maritime Applications of Prolonged Casualty Care: Drowning and Hypothermia on an Amphibious Warship 500
Comparison analysis of Apple face ID in iPad Pro 13” with first use of metasurfaces for diffraction vs. iPhone 16 Pro 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4063970
求助须知:如何正确求助?哪些是违规求助? 3602387
关于积分的说明 11441255
捐赠科研通 3325526
什么是DOI,文献DOI怎么找? 1828154
邀请新用户注册赠送积分活动 898633
科研通“疑难数据库(出版商)”最低求助积分说明 819103