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    Harmonization of Four Delirium Instruments: Creating Crosswalks and the Delirium Item-Bank (DEL-IB)

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    Authors
    Helfand, Benjamin K.I.
    Detroyer, Elke
    Milisen, Koen
    Adamis, Dimitrios
    Metzger, Eran D.
    Boudreaux, Edwin D
    Inouye, Sharon K.
    Jones, Richard N.
    UMass Chan Affiliations
    Graduate School of Biomedical Sciences
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2021-07-29
    Keywords
    Geriatrics
    Health Services Administration
    Health Services Research
    Psychiatry
    Psychiatry and Psychology
    
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    Link to Full Text
    https://doi.org/10.1016/j.jagp.2021.07.011
    Abstract
    OBJECTIVES: Over 30 instruments are in current, active use for delirium identification. In a recent systematic review, we recommended 4 commonly used and well-validated instruments for clinical and research use. The goal of this study is to harmonize the four instruments on the same metric using modern methods in psychometrics. DESIGN: Secondary data analysis from 3 studies, and a simulation study based on the observed data. SETTING: Hospitalized (non-ICU) adults over 65 years old in the United States, Ireland, and Belgium. PARTICIPANTS: The total sample comprised 600 participants, contributing 1,623 assessments. MEASUREMENTS: Confusion Assessment Method (long-form and short-form), Delirium Observation Screening Scale, Delirium Rating Scale-Revised-98 (DRS-R-98) (total and severity scores), and Memorial Delirium Assessment Scale. RESULTS: Using item response theory, we linked scores across instruments, placing all four instruments and their separate scorings on the same metric (the propensity to delirium). Kappa statistics comparing agreement in delirium identification among the instruments ranged from 0.37 to 0.75, with the highest agreement between the DRS-R-98 total score and MDAS. After linking scores, we created a harmonized item bank, called the Delirium Item Bank (DEL-IB), consisting of 50 items. The DEL-IB allowed us to create six crosswalks, to allow scores to be translated across instruments. CONCLUSIONS: With our results, individual instrument scores can be directly compared to aid in clinical decision-making, and quantitatively combined in meta-analyses.
    Source

    Helfand BKI, Detroyer E, Milisen K, Adamis D, Metzger ED, Boudreaux ED, Inouye SK, Jones RN. Harmonization of Four Delirium Instruments: Creating Crosswalks and the Delirium Item-Bank (DEL-IB). Am J Geriatr Psychiatry. 2021 Jul 29:S1064-7481(21)00397-3. doi: 10.1016/j.jagp.2021.07.011. Epub ahead of print. PMID: 34417086. Link to article on publisher's site

    DOI
    10.1016/j.jagp.2021.07.011
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29907
    PubMed ID
    34417086
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jagp.2021.07.011
    Scopus Count
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    Morningside Graduate School of Biomedical Sciences Scholarly Publications
    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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