Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

Abstract

BackgroundsReports of increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the pediatric delirium component (PD-scale) of the Sophia Observation Withdrawal Symptoms scale Pediatric Delirium scale (SOS-PD scale).MethodsIn a multicenter prospective observational study in four Dutch pediatric ICUs (PICUs), patients aged ≥ 3 months and admitted for ≥ 48 h were assessed with the PD-scale thrice daily. Criterion validity was assessed: if the PD-scale score was ≥ 4, a child psychiatrist clinically assessed the presence or absence of PD according to the Diagnostic and statistical manual of mental disorders (DSM)-IV. In addition, the child psychiatrist assessed a randomly selected group to establish the false-negative rate. The construct validity was assessed by calculating the Pearson coefficient (rp) for correlation between the PD-scale and Cornell Assessment Pediatric Delirium (CAP-D) scores. Interrater reliability was determined by comparing paired nurse-researcher PD-scale assessments and calculating the intraclass correlation coefficient (ICC).ResultsFour hundred eighty-five patients with a median age of 27.0 months (IQR 8–102) were included, of whom 48 patients were diagnosed with delirium by the child psychiatrist. The PD-scale had overall sensitivity of 92.3% and specificity of 96.5% compared to the psychiatrist diagnosis for a cutoff score ≥4 points. The rp between the PD-scale and the CAP-D was 0.89 (CI 95%, 0.82–0.93; p < 0.001). The ICC of 75 paired nurse-researcher observations was 0.99 (95% CI, 0.98–0.99).ConclusionsThe PD-scale has good reliability and validity for early screening of PD in critically ill children. It can be validly and reliably used by nurses to this aim.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2238-z) contains supplementary material, which is available to authorized users.

Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?

“…The CAPD assesses pediatric delirium within the context of child development by comparing the detection of specific items on a scale addressing consciousness, cognition, orientation, psychomotor activity, and affect/distress with anchor points that characterize the development of the patient by age groups (23,24). CAPD has been validated as a tool for detection of delirium in critically ill and/or younger oncology patients (14,25,26).…”

Accuracy of delirium assessments in critically ill children: A prospective, observational study during routine care

“…Previously, validation of the CAP-D and the psCAM-ICU/pCAM-ICU has primarily relied on trained, expert users, restricting the interpretation of those results for routine clinical use. Future research is required to directly compare the accuracy and feasibility of each of these tools, evaluate their use in other medical settings (e.g., general hospital wards, oncology), and extend comparison with other promising screening instruments not available at the time of conducting this study (i.e., the Sophia Observation Withdrawal Symptoms e Pediatric Delirium [SOS-PD] scale) 40…”

Current State of Analgesia and Sedation in the Pediatric Intensive Care Unit

“…The Pediatric Confusion Assessment Method for the ICU (pCAM-ICU) for age five years and older and the Preschool Confusion Assessment Method (psCAM-ICU) are also validated in children and have high reliability, with a high sensitivity and specificity of 83% and 99%, respectively [ 200 ]. The Sophia Observation withdrawal Symptoms scale-Pediatric Delirium scale (SOS-PD) is another validated tool for delirium screening in critically ill children, with measurement properties comparable to the CAPD, psCAM-ICU, and the pCAM-ICU and an overall sensitivity of 92.3% and specificity of 96.5% [ 205 , 206 , 207 ].…”