Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium

Validations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia. Cross-sectional study using two deli...

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Bibliographic Details
Published in:Journal of psychosomatic research 2024-10, Vol.185, p.111880, Article 111880
Main Authors: Botero Urrea, María, González, Maria Carolina, Villa García, María Margarita, Alviz Núñez, Marcela, Velásquez-Tirado, Juan D., Ocampo, María V., Trzepacz, Paula T., Franco, José G.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Comorbidity
Cross-Sectional Studies
Delirium - diagnosis
Dementia
Dementia - diagnosis
Depression
Depression - diagnosis
Diagnostic and Statistical Manual of Mental Disorders
Female
Geriatric assessment
Humans
Inpatients
Male
Psychiatric Status Rating Scales
Reproducibility of Results
Sensitivity and Specificity
Validation studies
Citations: Items that this one cites
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Summary:Validations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia. Cross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too. There were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3–95.9% vs DSM-5-TR and 92.7–95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (p 
ISSN:0022-3999
1879-1360
1879-1360
DOI:10.1016/j.jpsychores.2024.111880