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dc.contributor.authorSaczynski, Jane S.
dc.contributor.authorKosar, Cyrus M.
dc.contributor.authorXu, Guoquan
dc.contributor.authorPuelle, Margaret R.
dc.contributor.authorSchmitt, Eva
dc.contributor.authorJones, Richard Norman
dc.contributor.authorMarcantonio, Edward Ralph
dc.contributor.authorWong, Bonnie
dc.contributor.authorIsaza, Ilean
dc.contributor.authorInouye, Sharon
dc.date.accessioned2017-04-27T20:42:04Z
dc.date.issued2014
dc.identifierQuick submit: 2014-12-20T00:07:58-05:00
dc.identifier.citationSaczynski, Jane S., Cyrus M. Kosar, Guoquan Xu, Margaret R. Puelle, Eva Schmitt, Richard N. Jones, Edward R. Marcantonio, Bonnie Wong, Ilean Isaza, and Sharon K. Inouye. 2014. “A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium.” Journal of the American Geriatrics Society 62 (3) (February 10): 518–524. doi:10.1111/jgs.12684.en_US
dc.identifier.issn0002-8614en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32605865
dc.description.abstractOBJECTIVES: To compare chart- and interview-based methods for identification of delirium. DESIGN: Prospective cohort study. SETTING: Two academic medical centers. PARTICIPANTS: Individuals aged 70 and older undergoing major elective surgery (N = 300) (majority orthopedic surgery). MEASUREMENTS: Participants were interviewed daily during hospitalization for delirium using the Confusion Assessment Method (CAM; interview-based method), and their medical charts were reviewed for delirium using a validated chart-review method (chart-based method). Rate of agreement of the two methods and characteristics of those identified using each approach were examined. Predictive validity for clinical outcomes (length of stay, postoperative complications, discharge disposition) was compared. In the absence of a criterion standard, predictive value could not be calculated. RESULTS: The cumulative incidence of delirium was 23% (n = 68) according to the interview-based method, 12% (n = 35) according to the chart-based method, and 27% (n = 82) according to the combined approach. Overall agreement was 80%; kappa was 0.30. The methods differed in detection of psychomotor features and time of onset. The chart-based method missed delirium in individuals that the CAM identified who were lacking features of psychomotor agitation or inappropriate behavior. The CAM-based method missed chart-identified cases occurring during the night shift. The combined method had high predictive validity for all clinical outcomes. CONCLUSIONS: Interview- and chart-based methods have specific strengths for identification of delirium. A combined approach captures the largest number and broadest range of delirium cases.en_US
dc.language.isoen_USen_US
dc.publisherWiley-Blackwellen_US
dc.relation.isversionofdoi:10.1111/jgs.12684en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pubmed/24512042en_US
dash.licenseLAA
dc.subjectdeliriumen_US
dc.subjectmethodologyen_US
dc.subjectepidemiologyen_US
dc.titleA Tale of Two Methods: Chart and Interview Methods for Identifying Deliriumen_US
dc.typeJournal Articleen_US
dc.date.updated2014-12-20T05:07:58Z
dc.description.versionAccepted Manuscripten_US
dc.rights.holderSaczynski JS, Kosar CM, Xu G, Puelle MR, Schmitt E, Jones RN, Marcantonio ER, Wong B, Isaza I, Inouye SK
dc.relation.journalJournal of the American Geriatrics Societyen_US
dash.depositing.authorInouye, Sharon
dc.date.available2017-04-27T20:42:04Z
dc.identifier.doi10.1111/jgs.12684*
dash.contributor.affiliatedJones, Richard Norman
dash.contributor.affiliatedMarcantonio, Edward
dash.contributor.affiliatedInouye, Sharon


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