Publicación: Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients
Fecha
2022-07
Autores
Delgado Parada, E.
Morillo Cuadrado, Daniel Vicente
Saiz Ruiz, J
Cebollada Gracia, A.
Ayuso Mateos, J.L.
Cruz Jentoft, A.J.
Morillo Cuadrado, Daniel Vicente
Editor/a
Director/a
Tutor/a
Coordinador/a
Prologuista
Revisor/a
Ilustrador/a
Derechos de acceso
info:eu-repo/semantics/openAccess
Título de la revista
ISSN de la revista
Título del volumen
Editor
Elsevier
Resumen
Abstract
Background and objectives
The 4AT scale is a sensitive tool for screening delirium, which can be applied rapidly in clinical settings without any specific training. It has not been translated, adapted, and validated to assess Spanish older adults. The aims of the study are: to translate and adapt to Spanish culture the 4AT scale, to present evidence of the diagnostic accuracy of this version (4AT-ES) when applied in non-specialized hospital wards, and to assess the loss of diagnostic accuracy in presence of risk factors.
Methods
A prospective sample was independently assessed on the 4AT-ES and the reference standard. One hundred and twenty-one inpatients (70+ years) for whom a psychiatric assessment was requested were included. Out of them, 50 were diagnosed with delirium. Nurses without specific training applied the 4AT-ES, and experienced psychiatrists cast the reference standard diagnosis (DSM-V criteria).
Results
Patients with delirium were older and had more risk factors (more previous delirium episodes, a higher likelihood of prior dementia/cognitive impairment) than controls. The 4AT-ES had excellent validity, sensitivity (96%) , and specificity (83.1%). The area under the curve was 0.918; in the subsample with any of those risk factors, its value did not decrease.
Conclusion
The 4AT-ES version of the 4AT scale was developed. When applied by non-specifically trained, nursing staff it showed excellent validity, sensitivity, and specificity, even in a subsample with previous risk factors. All indices were comparable to the original version. We recommend its use for efficient delirium screening in hospitalized older patients with suspected delirium.
Descripción
La versión registrada de este artículo, publicado por primera vez en The European Journal of Psychiatry, Volume 36, Issue 3, 2022, Pages 182-190, está disponible en línea en el sitio web del editor: https://doi.org/10.1016/j.ejpsy.2022.01.003
The copyrighted version of this article, first published in The European Journal of Psychiatry, Volume 36, Issue 3, 2022, Pages 182-190, is available online at the publisher's website: https://doi.org/10.1016/j.ejpsy.2022.01.003
Categorías UNESCO
Palabras clave
Delirium screening, Translation, Diagnostic accuracy, Validation
Citación
E. Delgado-Parada, D. Morillo-Cuadrado, J Saiz-Ruiz, A. Cebollada-Gracia, J.L. Ayuso-Mateos, A.J. Cruz-Jentoft, Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients, The European Journal of Psychiatry, Volume 36, Issue 3, 2022, Pages 182-190, ISSN 0213-6163, https://doi.org/10.1016/j.ejpsy.2022.01.003.
Centro
Facultades y escuelas::Facultad de Psicología
Departamento
Metodología de las Ciencias del Comportamiento