Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro)

Abstract

Objective The Delirium Diagnostic Tool-Provisional (DDT-Pro) was designed to detect the presence and severity of delirium briefly and objectively regardless of psychiatric expertise. We translated the DDT-Pro into Korean and validated it in elderly Korean patients.Methods To validate the translation and evaluate inter-rater reliability, a psychiatric trainee and a research nurse independently assessed the same patients referred to the Department of Psychiatry. The results were compared with the reference evaluations performed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).Results We enrolled 42 elderly patients. The Cronbach’s alpha coefficient were 0.839 (the trainee), 0.822 (the nurse). The Cohen’s weighted κ between the trainee and nurse, ranged from 0.555±0.102 to 0.776±0.062. The Pearson correlation coefficients (Korean version of the DDT-Pro [K-DDT-Pro] and Korean version of the Delirium Rating Scale-Revised-98 [DRS-R98-K] total score) were γ=-0.850 (the trainee), and γ=-0.821 (the nurse). The areas under the ROC curves (AUCs) were 0.974 (the trainee) and 0.893 (the nurse).Conclusion The K-DDT-Pro exhibited high internal consistency and relatively substantial inter-rater reliability. The correlation with the DRS-R98-K was strongly negative. The accuracy of the K-DDT-Pro was excellent, regardless of expertise. In conclusion, the K-DDT-Pro is a brief and simple tool that usefully screens for delirium in elderly patients.

Delirium in psychiatric settings: risk factors and assessment tools in patients with psychiatric illness: a scoping review

“…The scores range from 9 points (best performance) to 0 (worst performance). Kim et al [ 63 ] translated the DDT-Pro into Korean and validated it in psychiatric setting. The DDT-Pro cutoff scores ≤ 6 and ≤ 7 have been shown to balance sensitivity and specificity in detecting delirium.…”

“…Furthermore, arousal is usually not impaired in patients with dementia, even in the advanced stages, but appears to be a specific indicator of delirium; arousal level assessment has shown promise for screening delirium superimposed on dementia (DSD). Additionally, Kim et al [ 63 ] validated the predictive value of DDT-Pro for delirium among patients referred to the department of psychiatry, which showed that DDT-Pro appeared to be satisfactory in identifying delirium and its subtype. The sensitivity and specificity of psychiatrist evaluation of delirium were higher at a cutoff value of 6 (84% and 94.1%) and 7 (100% and 82.4%) [ 63 ].…”

“…Additionally, Kim et al [ 63 ] validated the predictive value of DDT-Pro for delirium among patients referred to the department of psychiatry, which showed that DDT-Pro appeared to be satisfactory in identifying delirium and its subtype. The sensitivity and specificity of psychiatrist evaluation of delirium were higher at a cutoff value of 6 (84% and 94.1%) and 7 (100% and 82.4%) [ 63 ]. Although these tools are available and DRS-D-98 may be among the best, their limitations highlight the necessity of comprehensive clinical evaluation to accurately distinguish diagnoses.…”