“SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665)
Abstract Aim A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the ‘Single Question in Delirium’ (SQiD), in comparison to psychiatrist clinical interview. Methods Inpatients in...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-01-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-020-07504-x |
| _version_ | 1831675697547968512 |
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| author | Megan B. Sands Swapnil Sharma Lindsay Carpenter Andrew Hartshorn Jessica T. Lee Sanja Lujic Megan E. Congdon Angus M. Buchanan Meera Agar Janette L. Vardy |
| author_facet | Megan B. Sands Swapnil Sharma Lindsay Carpenter Andrew Hartshorn Jessica T. Lee Sanja Lujic Megan E. Congdon Angus M. Buchanan Meera Agar Janette L. Vardy |
| author_sort | Megan B. Sands |
| collection | DOAJ |
| description | Abstract Aim A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the ‘Single Question in Delirium’ (SQiD), in comparison to psychiatrist clinical interview. Methods Inpatients in two comprehensive cancer centres were prospectively screened. Clinical staff asked informants to respond to the SQiD: “Do you feel that [patient’s name] has been more confused lately?”. The primary endpoint was negative predictive value (NPV) of the SQiD versus psychiatrist diagnosis (Diagnostic and Statistics Manual criteria). Secondary endpoints included: NPV of the Confusion Assessment Method (CAM), sensitivity, specificity and Cohen’s Kappa coefficient. Results Between May 2012 and July 2015, the SQiD plus CAM was applied to 122 patients; 73 had the SQiD and psychiatrist interview. Median age was 65 yrs. (interquartile range 54–74), 46% were female; median length of hospital stay was 12 days (5–18 days). Major cancer types were lung (19%), gastric or other upper GI (15%) and breast (14%). 70% of participants had stage 4 cancer. Diagnostic values were similar between the SQiD (NPV = 74, 95% CI 67–81; kappa = 0.32) and CAM (NPV = 72, 95% CI 67–77, kappa = 0.32), compared with psychiatrist interview. Overall the CAM identified only a small number of delirious cases but all were true positives. The specificity of the SQiD was 87% (74–95) The SQiD had higher sensitivity than CAM (44% [95% CI 41–80] vs 26% [10–48]). Conclusion The SQiD, administered by bedside clinical staff, was feasible and its psychometric properties are now better understood. The SQiD can contribute to delirium detection and clinical care for hospitalised cancer patients. |
| first_indexed | 2024-12-20T04:08:45Z |
| format | Article |
| id | doaj.art-f6f8296fe04a4bb88d3ca8b241bf8045 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T04:08:45Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-f6f8296fe04a4bb88d3ca8b241bf80452022-12-21T19:53:59ZengBMCBMC Cancer1471-24072021-01-012111910.1186/s12885-020-07504-x“SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665)Megan B. Sands0Swapnil Sharma1Lindsay Carpenter2Andrew Hartshorn3Jessica T. Lee4Sanja Lujic5Megan E. Congdon6Angus M. Buchanan7Meera Agar8Janette L. Vardy9University of New South Wales, Prince of Wales Clinical SchoolUniversity of New South Wales, Prince of Wales Clinical SchoolUniversity of New South Wales, Prince of Wales Clinical SchoolConcord Cancer Centre, Concord Repatriation General HospitalConcord Cancer Centre, Concord Repatriation General HospitalCentre for Big Data Research in Health, University of New South WalesUniversity of New South Wales, Prince of Wales Clinical SchoolGosford HospitalCentre of Cardiovascular and Chronic Care, University of Technology Sydney Faculty of HealthConcord Cancer Centre, Concord Repatriation General HospitalAbstract Aim A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the ‘Single Question in Delirium’ (SQiD), in comparison to psychiatrist clinical interview. Methods Inpatients in two comprehensive cancer centres were prospectively screened. Clinical staff asked informants to respond to the SQiD: “Do you feel that [patient’s name] has been more confused lately?”. The primary endpoint was negative predictive value (NPV) of the SQiD versus psychiatrist diagnosis (Diagnostic and Statistics Manual criteria). Secondary endpoints included: NPV of the Confusion Assessment Method (CAM), sensitivity, specificity and Cohen’s Kappa coefficient. Results Between May 2012 and July 2015, the SQiD plus CAM was applied to 122 patients; 73 had the SQiD and psychiatrist interview. Median age was 65 yrs. (interquartile range 54–74), 46% were female; median length of hospital stay was 12 days (5–18 days). Major cancer types were lung (19%), gastric or other upper GI (15%) and breast (14%). 70% of participants had stage 4 cancer. Diagnostic values were similar between the SQiD (NPV = 74, 95% CI 67–81; kappa = 0.32) and CAM (NPV = 72, 95% CI 67–77, kappa = 0.32), compared with psychiatrist interview. Overall the CAM identified only a small number of delirious cases but all were true positives. The specificity of the SQiD was 87% (74–95) The SQiD had higher sensitivity than CAM (44% [95% CI 41–80] vs 26% [10–48]). Conclusion The SQiD, administered by bedside clinical staff, was feasible and its psychometric properties are now better understood. The SQiD can contribute to delirium detection and clinical care for hospitalised cancer patients.https://doi.org/10.1186/s12885-020-07504-xDeliriumDetectionScreeningOncologyCancerHospital |
| spellingShingle | Megan B. Sands Swapnil Sharma Lindsay Carpenter Andrew Hartshorn Jessica T. Lee Sanja Lujic Megan E. Congdon Angus M. Buchanan Meera Agar Janette L. Vardy “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) BMC Cancer Delirium Detection Screening Oncology Cancer Hospital |
| title | “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) |
| title_full | “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) |
| title_fullStr | “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) |
| title_full_unstemmed | “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) |
| title_short | “SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665) |
| title_sort | sqid the single question in delirium can a single question help clinicians to detect delirium in hospitalised cancer patients running heading single question in delirium bcan d 20 01665 |
| topic | Delirium Detection Screening Oncology Cancer Hospital |
| url | https://doi.org/10.1186/s12885-020-07504-x |
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