Background: Delirium is a common complication of hospitalized patients leading to worse outcomes. Screening tools can improve detection and prompt treatment. The 3-minute Diagnostic Interview for Confusion Assessment Method (CAM)-defined Delirium (3D-CAM) is a practical, valid, and reliable screening tool developed by Dr. Edward R. Marcantonio in 2014. The 3D-CAM was translated into Thai language. Objective: To demonstrate the validity and reliability of the Thai 3D-CAM compared to psychiatrist diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5). Methods: One hundred and forty-two patients were recruited with consent from the patients or a caregiver from adult inpatients requiring psychiatric consultation. Patients were assessed with the Thai 3D-CAM, the Thai Delirium Rating Scale-Revised-98 (DRS-R-98), followed by a psychiatric interview based on the DSM-5. Results: Delirium proportion in the study population was 48.6%. The most common motor subtype was mixed delirium (56.5%), followed by hyperactive (23.2%), and hypoactive delirium (20.3%). The sensitivity of the Thai 3DCAM was 91.3% (95% CI = 84.7 - 98.0), and specificity was 90.4% (95% CI = 83.6 - 97.2). Thai 3D-CAM results correlated with gold standard diagnosis, with 2 of 94.763 (P < 0.001), and Cohen’s kappa of 0.817 (95% CI = 0.723 - 0.911, P < 0.001). Internal consistency was demonstrated with Cronbach’s alpha = 0.708. Inter-rater reliability showed near perfect agreement (Kappa = 0.818, 95% CI = 0.577 - 1.059, P < 0.001). Conclusion: The Thai 3D-CAM is a valid and reliable screening tool for delirium. Availability of this screening tool could assist in improving detection and early treatment.
Faculty of Medicine, Chulalongkorn University
Thipakorn, Yanin and Thisayakorn, Paul
"Validity and reliability of the Thai 3-Minute Diagnostic Interview for CAM-defined Delirium (Thai 3D-CAM),"
Chulalongkorn Medical Journal: Vol. 65:
4, Article 4.
Available at: https://digital.car.chula.ac.th/clmjournal/vol65/iss4/4