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Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses

BACKGROUND: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity among hospitalized elderly patients. OBJECTIVE: To develop the Thai version of the 4AT (4AT-T) and assess its validity. SUBJECTS AND SETTING: A total of 97 elderly...

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Autores principales: Kuladee, Sanchai, Prachason, Thanavadee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771402/
https://www.ncbi.nlm.nih.gov/pubmed/26966365
http://dx.doi.org/10.2147/NDT.S97228
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author Kuladee, Sanchai
Prachason, Thanavadee
author_facet Kuladee, Sanchai
Prachason, Thanavadee
author_sort Kuladee, Sanchai
collection PubMed
description BACKGROUND: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity among hospitalized elderly patients. OBJECTIVE: To develop the Thai version of the 4AT (4AT-T) and assess its validity. SUBJECTS AND SETTING: A total of 97 elderly patients aged 60 years or above who were admitted to the general medical wards were included. METHODS: Both authors independently translated the English version of the 4AT into Thai and thereafter developed a single reconciled forward translation by consensus. Back translation was performed by a bilingual native English speaker and it was then reviewed to ensure its agreement with the original one. After 24 hours of admission, subjects were enrolled and clinical data collected. Definite diagnosis of delirium was made by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria and the 6-item Thai Delirium Rating Scale; the 4AT was then administered to participants by nurses within 30 minutes. A 4AT score ≥4 was considered positive for delirium screening. The optimal cut-off point of the 4AT-T was identified by Youden’s index. RESULTS: In all, 24 out of 97 participants met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria for delirium. At a cut-off score of 4 or greater, the 4AT-T exhibited satisfactory diagnostic performance with a sensitivity of 83.3% (95% confidence interval (CI): 62.6%–95.3%) and specificity of 86.3% (95% CI: 76.3%–93.2%). The area under the receiver operating characteristic curve was 0.92. The specified score provided maximal Youden’s index, suggesting an optimal criterion value for delirium screening. CONCLUSION: The 4AT-T is a valid delirium-screening instrument for hospitalized elderly patients with acute medical illnesses.
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spelling pubmed-47714022016-03-10 Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses Kuladee, Sanchai Prachason, Thanavadee Neuropsychiatr Dis Treat Original Research BACKGROUND: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity among hospitalized elderly patients. OBJECTIVE: To develop the Thai version of the 4AT (4AT-T) and assess its validity. SUBJECTS AND SETTING: A total of 97 elderly patients aged 60 years or above who were admitted to the general medical wards were included. METHODS: Both authors independently translated the English version of the 4AT into Thai and thereafter developed a single reconciled forward translation by consensus. Back translation was performed by a bilingual native English speaker and it was then reviewed to ensure its agreement with the original one. After 24 hours of admission, subjects were enrolled and clinical data collected. Definite diagnosis of delirium was made by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria and the 6-item Thai Delirium Rating Scale; the 4AT was then administered to participants by nurses within 30 minutes. A 4AT score ≥4 was considered positive for delirium screening. The optimal cut-off point of the 4AT-T was identified by Youden’s index. RESULTS: In all, 24 out of 97 participants met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria for delirium. At a cut-off score of 4 or greater, the 4AT-T exhibited satisfactory diagnostic performance with a sensitivity of 83.3% (95% confidence interval (CI): 62.6%–95.3%) and specificity of 86.3% (95% CI: 76.3%–93.2%). The area under the receiver operating characteristic curve was 0.92. The specified score provided maximal Youden’s index, suggesting an optimal criterion value for delirium screening. CONCLUSION: The 4AT-T is a valid delirium-screening instrument for hospitalized elderly patients with acute medical illnesses. Dove Medical Press 2016-02-24 /pmc/articles/PMC4771402/ /pubmed/26966365 http://dx.doi.org/10.2147/NDT.S97228 Text en © 2016 Kuladee and Prachason. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Kuladee, Sanchai
Prachason, Thanavadee
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title_full Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title_fullStr Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title_full_unstemmed Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title_short Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
title_sort development and validation of the thai version of the 4 ‘a’s test for delirium screening in hospitalized elderly patients with acute medical illnesses
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771402/
https://www.ncbi.nlm.nih.gov/pubmed/26966365
http://dx.doi.org/10.2147/NDT.S97228
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AT prachasonthanavadee developmentandvalidationofthethaiversionofthe4astestfordeliriumscreeninginhospitalizedelderlypatientswithacutemedicalillnesses