Comparative Accuracy and Efficiency of Four Delirium Screening Protocols.

Area of Science:

• Gerontology
• Clinical Medicine
• Healthcare Management

Background:

• Systematic delirium screening improves detection but is often limited by time constraints.
• Delirium is a common and serious condition in hospitalized older adults.
• Efficient screening tools are crucial for timely diagnosis and management.

Purpose of the Study:

• To compare the time efficiency, sensitivity, and specificity of four delirium screening protocols.
• To evaluate the impact of a skip pattern on assessment duration.
• To identify the most time-efficient protocol for systematic delirium screening.

Main Methods:

• A comparative efficiency simulation study using secondary data from two previous studies (3D-CAM and READI).
• Simulated administration of four protocols: full 3D-CAM, 3D-CAM with skip, UB-2 followed by 3D-CAM in positives, and UB-2 followed by 3D-CAM with skip in positives.
• Calculated sensitivity, specificity, and median administration times for each protocol.

Main Results:

• All four protocols demonstrated similar simulated sensitivity and specificity.
• The UB-2 followed by 3D-CAM with skip in positives was the fastest protocol, averaging 1 minute 14 seconds.
• This protocol was significantly faster (1 minute 59 seconds) than the full 3D-CAM.
• The UB-2 + 3D-CAM with skip protocol offers substantial time savings.

Conclusions:

• The UB-2 combined with 3D-CAM with skip pattern (UB-CAM) is a highly time-efficient delirium screening protocol.
• This protocol shows promise for increasing the implementation of systematic delirium screening in hospitalized older adults.
• Optimizing screening time can facilitate broader adoption and improve patient outcomes.