Pediatric delirium

Evaluating the gold standard

Gabrielle Silver*, Julia Kearney, Chani Traube, Thomas M. Atkinson, Katarzyna E. Wyka, John Walkup

*Corresponding author for this work

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: Our aim was to evaluate interrater reliability for the diagnosis of pediatric delirium by child psychiatrists. Method: Critically ill patients (N = 17), 0-21 years old, including 7 infants, 5 children with developmental delay, and 7 intubated children, were assessed for delirium using the Diagnostic and Statistical Manual-IV (DSM-IV) (comparable to DSM-V) criteria. Delirium assessments were completed by two psychiatrists, each blinded to the other's diagnosis, and interrater reliability was measured using Cohen's κ coefficient along with its 95% confidence interval. Results: Interrater reliability for the psychiatric assessment was high (Cohen's κ = 0.94, CI [0.83, 1.00]). Delirium diagnosis showed excellent interrater reliability regardless of age, developmental delay, or intubation status (Cohen's κ range 0.81-1.00). Significance of results: In our study cohort, the psychiatric interview and exam, long considered the gold standard in the diagnosis of delirium, was highly reliable, even in extremely young, critically ill, and developmentally delayed children. A developmental approach to diagnosing delirium in this challenging population is recommended.

Original languageEnglish (US)
Pages (from-to)513-516
Number of pages4
JournalPalliative and Supportive Care
Volume13
Issue number3
DOIs
StatePublished - Jun 13 2013

Fingerprint

Delirium
Pediatrics
Psychiatry
Critical Illness
Intubation
Reproducibility of Results
Diagnostic and Statistical Manual of Mental Disorders
Cohort Studies
Confidence Intervals
Interviews
Population

Keywords

  • Child psychiatry
  • Delirium
  • Pediatric critical care

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Silver, G., Kearney, J., Traube, C., Atkinson, T. M., Wyka, K. E., & Walkup, J. (2013). Pediatric delirium: Evaluating the gold standard. Palliative and Supportive Care, 13(3), 513-516. https://doi.org/10.1017/S1478951514000212
Silver, Gabrielle ; Kearney, Julia ; Traube, Chani ; Atkinson, Thomas M. ; Wyka, Katarzyna E. ; Walkup, John. / Pediatric delirium : Evaluating the gold standard. In: Palliative and Supportive Care. 2013 ; Vol. 13, No. 3. pp. 513-516.
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Silver, G, Kearney, J, Traube, C, Atkinson, TM, Wyka, KE & Walkup, J 2013, 'Pediatric delirium: Evaluating the gold standard', Palliative and Supportive Care, vol. 13, no. 3, pp. 513-516. https://doi.org/10.1017/S1478951514000212

Pediatric delirium : Evaluating the gold standard. / Silver, Gabrielle; Kearney, Julia; Traube, Chani; Atkinson, Thomas M.; Wyka, Katarzyna E.; Walkup, John.

In: Palliative and Supportive Care, Vol. 13, No. 3, 13.06.2013, p. 513-516.

Research output: Contribution to journalArticle

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T2 - Evaluating the gold standard

AU - Silver, Gabrielle

AU - Kearney, Julia

AU - Traube, Chani

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AU - Wyka, Katarzyna E.

AU - Walkup, John

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N2 - Objective: Our aim was to evaluate interrater reliability for the diagnosis of pediatric delirium by child psychiatrists. Method: Critically ill patients (N = 17), 0-21 years old, including 7 infants, 5 children with developmental delay, and 7 intubated children, were assessed for delirium using the Diagnostic and Statistical Manual-IV (DSM-IV) (comparable to DSM-V) criteria. Delirium assessments were completed by two psychiatrists, each blinded to the other's diagnosis, and interrater reliability was measured using Cohen's κ coefficient along with its 95% confidence interval. Results: Interrater reliability for the psychiatric assessment was high (Cohen's κ = 0.94, CI [0.83, 1.00]). Delirium diagnosis showed excellent interrater reliability regardless of age, developmental delay, or intubation status (Cohen's κ range 0.81-1.00). Significance of results: In our study cohort, the psychiatric interview and exam, long considered the gold standard in the diagnosis of delirium, was highly reliable, even in extremely young, critically ill, and developmentally delayed children. A developmental approach to diagnosing delirium in this challenging population is recommended.

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