E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft
{"title":"西班牙版4AT量表(4AT- es)对老年住院患者谵妄筛查的诊断准确性","authors":"E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft","doi":"10.1016/j.ejpsy.2022.01.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":"{\"title\":\"Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients\",\"authors\":\"E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft\",\"doi\":\"10.1016/j.ejpsy.2022.01.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":12045,\"journal\":{\"name\":\"European Journal of Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0213616322000040\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0213616322000040","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients
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.
期刊介绍:
The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.