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@article{989159, author = {Bednařík, Josef and Ely, E. Wesley}, article_location = {Philadelphia}, article_number = {7}, doi = {http://dx.doi.org/10.1097/CCM.0b013e3182515042}, keywords = {delirium; stroke; sensitivity; specificity}, language = {eng}, issn = {0090-3493}, journal = {Critical Care Medicine}, title = {Delirium detection in stroke patients - Reply}, url = {http://journals.lww.com/ccmjournal/Citation/2012/07000/Delirium_detection_in_stroke_patients.59.aspx}, volume = {40}, year = {2012} }
TY - JOUR ID - 989159 AU - Bednařík, Josef - Ely, E. Wesley PY - 2012 TI - Delirium detection in stroke patients - Reply JF - Critical Care Medicine VL - 40 IS - 7 SP - 2267-2268 EP - 2267-2268 PB - Lippincott Williams & Wilkins SN - 00903493 KW - delirium KW - stroke KW - sensitivity KW - specificity UR - http://journals.lww.com/ccmjournal/Citation/2012/07000/Delirium_detection_in_stroke_patients.59.aspx L2 - http://journals.lww.com/ccmjournal/Citation/2012/07000/Delirium_detection_in_stroke_patients.59.aspx N2 - The autors evaluated the test characteristics of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in a consecutive series of 129 stroke patients, and found a sensitivity of 76%, specificity of 98%, and overall accuracy of 94% (95% CI 88% to 97%) as compared with the reference standard DSM IV rater for diagnosing delirium. The challenge in this cohort was the presence of a fresh stroke an added comorbidity in each patient. The authors found the data very affirming that indeed non-psychiatrists have a tool which, if performed according to the Training Manual (www.icudelirium.org) will provide valid and reliable data about the presence or absence of delirium in stroke patients. While they do not believe that this instrument replaces a full neurologic or psychiatric consultation in all patients, they do believe that these data address a driving unmet need of interdisciplinary teams as a way forward in which “non-delirium experts” may proceed to implement delirium evaluations in routine practice. Sensitivity of any brief tool might be influenced by many factors such as education and training of the rater and might be lower compared with research settings. With appropriate implementation science and teamwork, the authors have achieved very high sensitivity and specificity in clinical practice across many ICU types. ER -
BEDNAŘÍK, Josef and E. Wesley ELY. Delirium detection in stroke patients - Reply. \textit{Critical Care Medicine}. Philadelphia: Lippincott Williams \&{} Wilkins, 2012, vol.~40, No~7, p.~2267-2268. ISSN~0090-3493. Available from: https://dx.doi.org/10.1097/CCM.0b013e3182515042.
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