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Related Experiment Videos

Diagnosing delirium by telephone

E R Marcantonio1, M Michaels, N M Resnick

  • 1Division of General Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Journal of General Internal Medicine
|October 1, 1998
PubMed
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Telephone interviews can effectively rule out delirium in older adults after hip fracture. However, positive delirium diagnoses require confirmation with a face-to-face assessment for accuracy.

Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Clinical Diagnostics

Background:

  • Delirium is a common and serious condition in older adults, particularly after surgery.
  • Accurate and timely diagnosis of delirium is crucial for effective patient management.
  • Traditional diagnostic methods often require in-person assessments, which can be challenging for some patients.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of telephone interviews for delirium in elderly patients.
  • To compare telephone-based delirium assessment with a gold-standard face-to-face evaluation.

Main Methods:

  • 41 subjects aged 65+ were interviewed by telephone and then face-to-face one month post-hip fracture repair.
  • Utilized the modified telephone Mini-Mental State Examination and Delirium Symptom Interview.

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  • Delirium diagnosis was based on the Confusion Assessment Method (CAM) algorithm.

    • Main Results:

    • Telephone interviews demonstrated high sensitivity (1.00) in detecting delirium.
    • Specificity was also high (0.94), correctly identifying most non-delirious patients.
    • All 6 delirious patients were identified via telephone; 33 of 35 non-delirious patients were correctly identified.

    Conclusions:

    • Telephone interviews are a viable tool for ruling out delirium in this population.
    • A positive diagnosis of delirium via telephone should be confirmed with a face-to-face assessment.
    • This approach is particularly important in low-prevalence populations to minimize false positives.