Verifying the Japanese version of the Preschool Confusion Assessment Method for the ICU (psCAM‐ICU)

Abstract

Aim Pediatric delirium has been well investigated and its prevalence is reported to be from 20% to 44%. For pediatric intensive care settings, several validated assessment tools for diagnosing delirium, including the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM‐ICU), are available in English. However, validated assessment tools for identifying pediatric delirium are unavailable in Japanese. Therefore, the aim of this study is to verify the Japanese translation of the psCAM‐ICU. Methods We enrolled patients at the Pediatric ICU at University of Tsukuba Hospital (Tsukuba, Japan) from May 2017 to February 2019. Enrollment criteria included patients aged 6 months to 5 years, and we excluded coma patients scoring under −4 on the Richmond Agitation–Sedation Scale or suffering from stroke. Pediatric patient delirium was simultaneously evaluated by three medical workers (pediatric intensivist and researchers). Psychiatrists then verified these findings against criteria of the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. We evaluated criterion validity (sensitivity and specificity) and reliability using Cohen's κ coefficient. Results We made a total of 56 independent assessments of 19 patients (42% female) with an average age of 18 (±15) weeks. Mechanical ventilation was used at least once in 73% of patients and the positive rate of delirium was 54% in total observation. Overall, the psCAM‐ICU showed high sensitivity, specificity (sensitivity, 0.90 [95% confidence interval [CI], 0.80–0.94]; specificity, 0.93 [95% CI, 0.83–0.97]), and high reliability within the researcher assessments (κ = 0.92; 95% CI, 0.82–1.0). Conclusion We verified the psCAM‐ICU and it shows high validity and reliability.

Preschool Confusion Assessment Method for the Intensive Care Unit–Spanish (psCAM-ICU-S): Cross-Cultural Adaptation and Validation in Colombia

“…Finally, in the effectiveness evaluation, we obtained a specificity of 94.8%, a sensitivity of 93.3%, a PPV of 78%, and a NPV of 99%. These results were in line with those reported by the initial psCAM-ICU study ( 8 ) and validations carried out in other languages ( 20 ). Furthermore, the psCAM-ICU-S demonstrated excellent reliability with a kappa index of 0.78 ( 21 ).…”

A Systematic Review and Pooled Prevalence of Delirium in Critically Ill Children*

“…Twenty-seven (16, 18–22, 35, 38–43, 45–59) were prospective in design, two retrospective (36, 37), and two point prevalence (44, 58). Twenty-seven were single-center studies (16, 18–21, 36–43, 45–57, 59), and four were multicenter studies (22, 35, 44, 58), including two multisite point prevalence studies (44, 58). Twenty-seven took place in a PICU (16, 18–22, 35–43, 45–49, 52–54, 56–59), two in a PCICU (51, 55), one in a mixed PICU and PCICU (50), and one across multiple PCICUs or PICUs (44).…”

“…The 31 studies reported on 9,756 children. Twenty studies reported prevalence of PD using CAPD (18, 36–38, 40, 41, 43–46, 48, 50, 51, 53–59) or translated versions (40, 45, 46, 48, 53, 54), eight using variations of the pCAM-ICU (16, 19, 20, 35, 39, 47, 49, 52), and three the SOS-PD (21, 22, 42).…”

“…Prevalence was reported per patient ( n = 23) (19–22, 36–39, 41–46, 48–52, 56–59), per assessment ( n = 4) (18, 40, 47, 53), or both ( n = 4) (16, 35, 54, 55). Prevalence of PD using the CAPD tool ranged from 17% to 66% (18, 36–38, 40, 41, 43–46, 48, 50, 51, 53–59), 7% to 54% using age appropriate CAM-ICU (16, 19, 20, 35, 39, 47, 49, 52), and 10% to 25% using the SOS-PD (21, 22, 42). A pooled PD prevalence of 34% (95% CI, 27–41) was estimated from 17 studies that reported prevalence per patient using CAPD ( Fig.…”

“…Ventilation status and MV time are reported to be associated with a diagnosis of PD (20, 22, 37, 38, 44, 47, 49, 51, 55–58). Increases in MV time from 1.4 to four times were reported in patients with a diagnosis of PD (21, 37, 38, 44, 51, 55–57).…”