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3-Minute Diagnostic Assessment Accurately IDs Delirium

High specificity and sensitivity with three-minute assessment for elderly with, without dementia

MONDAY, Oct. 20, 2014 (HealthDay News) -- A three-minute diagnostic assessment (3D-Confusion Assessment Method [CAM]) has high sensitivity and specificity for identifying delirium, according to a study published in the Oct. 21 issue of the Annals of Internal Medicine.

Edward R. Marcantonio, M.D., from the Beth Deaconess Medical Center in Boston, and colleagues developed and validated the 3D-CAM among 201 inpatients aged 75 years and older. The 20 items that best operationalized the four CAM diagnostic features were identified to create the 3D-CAM. Assessments were administered by trained research assistants for prospective validation. Patient and family interviews and medical records were independently assessed by clinicians. The 3D-CAM delirium diagnosis was compared with the reference standard.

The researchers found that delirium was identified in 21 percent of the patients based on expert panel assessment, 88 percent of whom had hypoactive or normal psychomotor features. The 3D-CAM median administration time was three minutes, and sensitivity and specificity were 95 and 94 percent, respectively. 3D-CAM performance was good in patients with dementia (sensitivity and specificity, 96 and 86 percent, respectively) and in those without dementia (sensitivity and specificity, 93 and 96 percent, respectively).

"The 3D-CAM operationalizes the CAM algorithm using a three-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium," the authors write.

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