Detecting delirium in patients with acute stroke: a systematic review of test accuracy

BMC Neurology

Table 3 Delirium detection tools emerged from the included studies: comparison in the diagnostic test accuracy properties documented

Tool	Author, year [reference]	Sensitivity % (95% CI)	Specificity % (95% CI)	Positive predictive value % (95% CI)	Negative predictive value % (95% CI)	Internal consistency (Cronbach α)	Accuracy % (95% CI)	Interrater reliability (Ƙ)	Likelihood ratio	AUC	Gold standard considered
4AT	Infante et al., 2017 [20]	90.2^b	64.5^b							0.82^a	DSM-V criteria
		96.4^c	76.7^c							0.88^b
	Kutlubaev et al., 2016 [21]	93	86	86	85.6	0.80				0.89	DSM-IV criteria
	Lees et al., 2013 [22]	100 (74–100)	82 (72–89)	43	100						CAM
		100^a (72–100)	83^a (73–88)								CAM
CAM-ICU	Mitasova et al., 2012 [8]	76 (55–91)	98 (93–100)	91 (70–99)	94 (88–98)		94^d (88–97)	0.94 (0.83–1.00)	0.47 (0.27–0.83)		DSM-IV criteria
AMT-10	Lees et al., 2013 [22]	75 (43–95)	61 (51–71)	21	95						CAM
AMT-4	Lees et al., 2013 [22]	83 (52–98)	61 (51–71)	23	96						CAM
CDT	Lees et al., 2013 [22]	67 (22–96)	38 (28–49)	7	95						CAM
COG4	Lees et al., 2013 [22]	70 (35–93)	44 (35–55)	13	92						CAM
GCS	Lees et al., 2013 [22]	17 (2–48)	81 (71–88)	11	88						CAM
“Does this patient has cognitive issues?“^e	Lees et al., 2013 [22]	58 (28–85)	85 (76–92)	35	93						CAM

^asubgroup analysis, excluding patients with severe aphasia (n = 7; over 111 patients included); ^bat the admission; ^cafter 7 days; ^dconsidered as ratio: true-positives + true-negatives/true positives + false-positives + true-negatives + false-negatives; ^ethe single question was asked to healthcare professionals of the multidisciplinary team
4AT: 4-Assessment Test for delirium, AMT: Abbreviated Mental Test, AUC Area Under the Curve, CAM: Confusion Assessment Method, CAM-ICU: Confusion Assessment Method for the Intensive Care Unit, CDT: Clock Drawing Test, CI: Confidence of Interval, COG4: cognitive examination derived from National Institutes of Health Stroke Scale (NIHSS), DSM: Diagnostic and Statistical Manual of mental disorders, GCS: Glasgow Coma Scale.

ISSN: 1471-2377