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Published on: February 14, 2014
Testing the functional assessment of mentation: A mobile application based assessment of mental status
David E Hamilton1, Valerie G Press2, Nicole M Twu2
1Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
Background:
Altered mental status is a significant predictor of mortality in hospitalized patients and a prerequisite component to the diagnosis of delirium. However, the detection of altered mental status is often incomplete, inaccurate, and resource intensive.
Objective:
To identify the clinical utility and feasibility of the Functional Assessment of Mentation (FAM(TM) ), a mobile application for evaluating attention and recall.
Design:
Prospective observational pilot study.
Setting:
Tertiary care medical center.
Participants:
Nine hundred thirty-one adult subjects (612 nonhospitalized and 319 hospitalized).
Measurements:
Score distribution and time to FAM(TM) completion were compared between nonhospitalized and hospitalized subjects (as well as between hospitalized subjects discharged home and those not discharged home). Additionally, in the hospitalized subgroup, FAM(TM) was compared to the Glasgow Coma Scale (GCS), using the Short Portable Mental Status Questionnaire (SPMSQ) as our criterion standard for altered mental status assessment.
Results:
Median time to completion of FAM(TM) was 55 seconds (interquartile range [IQR], 45-67 seconds). Our data identified a graded reduction in score comparing nonhospitalized subjects to hospitalized subjects discharged home and not discharged home (median 5 [IQR 4-7] vs 5 [IQR 3-6] vs 3 [IQR 1-5]; P < 0.001). In the hospitalized subset, FAM(TM) scores were more highly correlated to SPMSQ (Spearman ρ = 0.27, P < 0.001) compared to GCS (Spearman ρ = 0.05, P = 0.40).
Conclusions:
FAM(TM) is a rapid and clinically feasible tool that can identify minor alterations in mental status often missed by GCS. Journal of Hospital Medicine 2016;11:463-466. 2016 Society of Hospital Medicine.
