Psychometric properties of the Arabic version of the confusion assessment method for the intensive care unit (CAM-ICU)

Aljuaid, Maha; Deeb, Ahmad M.; Dbsawy, Maamoun; Alsayegh, Daniah; Alotaibi, Moteb; Arabi, Yaseen M.

doi:10.1186/s12888-018-1676-0

Cited by 13 publications

(10 citation statements)

References 41 publications

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“…The CAM-ICU is a valid and reliable delirium assessment tool. Patients with a RASS score of − 3 or lower will be excluded from CAM-ICU assessment, as they cannot participate in the exam [26]. We will calculate the modified Clinical Pulmonary Infection Score (CPIS) to differentiate secretions caused by patients' underlying lung pathology (ventilator-associated pneumonia [VAP]) vs ketamine-associated hypersalivation [27].…”

Section: Data Managementmentioning

confidence: 99%

Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial

Bawazeer

Amer

Maghrabi

et al. 2020

Trials

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Background: A noticeable interest in ketamine infusion for sedation management has developed among critical care physicians for critically ill patients. The 2018 Pain, Agitation/sedation, Delirium, Immobility, and Sleep disruption guideline suggested low-dose ketamine infusion as an adjunct to opioid therapy to reduce opioid requirements in post-surgical patients in the intensive care unit (ICU). This was, however, rated as conditional due to the very low quality of evidence. Ketamine has favorable characteristics, making it an especially viable alternative for patients with respiratory and hemodynamic instability. The Analgo-sedative adjuncT keTAmine Infusion iN Mechanically vENTilated ICU patients (ATTAINMENT) trial aims to assess the effect and safety of adjunct low-dose continuous infusion of ketamine as an analgo-sedative compared to standard of care in critically ill patients on mechanical ventilation (MV) for ≥ 24 h.Methods/design: This trial is a prospective, randomized, active controlled, open-label, pilot, feasibility study of adult ICU patients (> 14 years old) on MV. The study will take place in the adult ICUs in the King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, and will enroll 80 patients. Patients will be randomized postintubation into two groups: the intervention group will receive an adjunct low-dose continuous infusion of ketamine plus standard of care. Ketamine will be administered over a period of 48 h at a fixed infusion rate of 2 μg/ kg/min (0.12 mg/kg/h) in the first 24 h followed by 1 μg/kg/min (0.06 mg/kg/h) in the second 24 h. The control group will receive standard of care in the ICU (propofol and/or fentanyl and/or midazolam) according to the KFSH&RC sedation and analgesia protocol as clinically appropriate. The primary outcome is MV duration until ICU discharge, death, extubation, or 28 days post-randomization, whichever comes first.

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Section: Data Managementmentioning

confidence: 99%

Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial

Bawazeer

Amer

Maghrabi

et al. 2020

Trials

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“…Table S3 presents the characteristics of the 29 studies. Twenty-three and 8 studies reported accuracy estimates for CAM-ICU (Adamis et al, 2012;Aljuaid et al, 2018;Barman et al, 2018;Boettger et al, 2018;Chanques et al, 2018;Chuang et al, 2007;Ely, Margolin, et al, 2001;Guenther et al, 2010;Gusmao-Flores et al, 2011;Heo et al, 2011;Karlicic et al, 2016;Koga et al, 2015;Lin et al, 2004;Luetz et al, 2010;Mitášová et al, 2012;Nishimura et al, 2016;Pipanmekaporn et al, 2014;Selim et al, 2018;van Eijk et al, 2011;van Eijk et al, 2009;Vreeswijk et al, 2009;Wang et al, 2013) and ICDSC (Barman et al, 2018;Bergeron et al, 2001;Boettger et al, 2018;Chanques et al, 2018;Gusmao-Flores et al, 2011;Kose, Bolu, Ozdemir, Acikel, & Hatipolu, 2016;Nishimura et al, 2016;van Eijk et al, 2009), respectively. Two studies applied Delirium Detection Score (DDS) (Luetz et al, 2010;Otter et al, 2005), one applied Cognitive Test for Delirium (CTD) alone (Hart et al, 1996), one applied Stanford Proxy Test for Delirium (S-PTD) alone (Alosaimi et al, 2018), one applied Neelon and Champagne Confusion Scale (NEECHAM) alone (Immers, Schuurmans, & Van De Bijl, 2005), and one applied Nursing Delirium Screening Scale (Nu-DESC) for delirium assessmen...…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis

Montgomery

Traynor

et al. 2020

Worldviews Ev Based Nurs

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Background Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment. Aim To evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients. Methods We searched five electronic databases including the Cochrane Library, PubMed, Embase, CINAHL, and a Chinese database for eligible diagnostic studies published in English or Mandarin up to December 2018. This diagnostic test accuracy meta‐analysis was limited to studies in intensive care unit (ICU) settings, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a standard reference to test the accuracy of delirium assessment tools. Eligible studies were critically appraised by two investigators independently. The summary of evidence was conducted for pooling and comparing diagnostic accuracy by a bivariate random effects meta‐analysis model. The pooled sensitivities and specificities, summary receiver operating characteristic curve (sROC), the area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated and plotted. The possibility of publication bias was assessed by Deeks’ funnel plot. Data Synthesis We identified and evaluated 23 and 8 articles focused on CAM‐ICU and ICDSC, respectively. The summary sensitivities of 0.85 and 0.87, and summary specificities of 0.95 and 0.91 were found for CAM‐ICU and ICDSC, respectively. The AUC of the CAM‐ICU was 0.96 (95% CI, 0.94–0.98), with DOR at 99 (95% CI, 55–177). The AUC of the ICDSC was 0.95 (95% CI, 0.92–0.96), and the DOR was 65 (95% CI, 27–153). Linking Evidence to Action CAM‐ICU demonstrated higher diagnostic test accuracy and is recommended as the optimal delirium assessment tool. However, the results should be interpreted with caution due to the between‐study heterogeneity of this diagnostic test accuracy meta‐analysis.

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“…First, although back-translation combined with both monolingual and bilingual tests is the most complete instrument for the translation procedure [25], the above method could not be used in this study because there were not enough bilingual subjects. Secondly, as in previous validation studies [11,14,28,29,31], patients with dementia and neuropsychiatric diseases were excluded. Further studies are needed to assess the psychometric properties of CAM-ICU in those patients.…”

Section: Validity: Internal Consistency Sensitivity and Specificitymentioning

confidence: 99%

A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation

Saida

Kortli

Amamou

et al. 2020

Preprint

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Background. Delirium is common in critically ill patients and it is associated with poor outcomes. In Tunisia, however, it is still underdiagnosed as there is no validated screening tool. The aim of this study was to translate and to validate a Tunisian version of the CAM-ICU. Methods. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in the patients admitted to the ICU between October 2017 and June 2018. All the patients consecutively admitted to the ICU for more than 24 hours and having a Richmond Agitation-Sedation Scale greater than or equal to “-3” were assessed for delirium excluding those with stroke, dementia, psychosis or persistent coma. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The inter-rater reliability was calculated using the kappa (κ) statistic. The CAM-ICU concurrent validity was assessed using Cronbach’s α coefficient, sensitivity, specificity as well as positive and negative predictive values (PPV and NPV, respectively) for the two Tunisian CAM-ICU raters. Results. The study involved 137 patients [median (IQR) age: 60 [49-68] years, male sex (n=102), invasive mechanical ventilation (n=49)]. Using the DSM-V criteria evaluations, 46 patients were diagnosed with delirium. When applying the Tunisian version of the CAM-ICU, 38(27.7%) patients were diagnosed with delirium for the first rater and 45(32.6%) patients for the second one. The Tunisian CAM-ICU showed a very-high inter-rater reliability for both intensivists (κ = 0.844, p<0.001). Using the DSM-V rater as the reference standard, the sensitivity of the two intensivists’ evaluations was 80.4 vs. 95.7%. Specificity was 98.9% for both. The Cronbach’s α of the first and second raters’ evaluations using the Tunisian version of the CAM-ICU were 0.886 and 0.887, respectively. Conclusions. The Tunisian version of the CAM-ICU showed almost perfect validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training. Trial registration. Not applicable.

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Psychometric properties of the Arabic version of the confusion assessment method for the intensive care unit (CAM-ICU)

Cited by 13 publications

References 41 publications

Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial

Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial

Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis

A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation

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