Validation of the Malay 3-minute diagnostic interview for confusion assessment method in a surgical population

Loh, Pui San and Chin, Yi Zhe and Lee, Jia Wen and Wong, Angelvene and Mansor, Marzida and Ng, Chong Guan and Cowan, David and Chan, Matthew TV and Wang, Chew Yin (2021) Validation of the Malay 3-minute diagnostic interview for confusion assessment method in a surgical population. Neurology Asia, 26 (4). pp. 721-729. ISSN 1823-6138, DOI

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Background: Delirium is a common postoperative complication among elderly which can be easily missed and leads to poorer outcomes. The 3-Minute Diagnostic Assessment for Confusion Assessment Method (3D-CAM) is a short and structured tool to assess delirium by healthcare staff with minimal training. This study aimed to validate the translated Malay 3D-CAM (M3D-CAM) in postoperative surgical patients. Methods: In this prospective diagnostic study, 3D-CAM was translated into Malay and two assessors (1 and 2) independently interviewed surgical patients above 65 years old with M3D-CAM on postoperative day one. A psychiatrist diagnosed postoperative delirium according to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) as the reference standard. The sequence of examinations was done randomly with all results blinded to each other and the diagnostic characteristics of M3D-CAM analysed with x coefficient used to evaluate reliability. Results: A total of 427 patients were screened, 111 recruited with a final 100 paired interviews completed. Their mean age was 72 (+/- 6) years old. Two-thirds of patients were proficient in Malay and English, therefore assessed in both 3D-CAM and M3D-CAM. Delirium was identified in 11% and 12% of patients by assessors 1 and 2 respectively while compared to DSM-5, M3D-CAM had 80% and 90% sensitivity with 96.7% and 97.7% specificity. M3D-CAM had excellent inter-rater reliability (85%), substantial parallel reliability (70%) and features 1 and 3 with substantial parallel agreement (p <0.001).

Item Type: Article
Uncontrolled Keywords: Delirium; Confusion Assessment Method; 3-minute diagnostic; 3D-CAM; Malay 3D CAM; Validation
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 17 Feb 2022 02:46
Last Modified: 17 Feb 2022 02:46

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