TY - JOUR
T1 - Pediatric delirium
T2 - Evaluating the gold standard
AU - Silver, Gabrielle
AU - Kearney, Julia
AU - Traube, Chani
AU - Atkinson, Thomas M.
AU - Wyka, Katarzyna E.
AU - Walkup, John
N1 - Publisher Copyright:
Copyright © Cambridge University Press 2014.
PY - 2013/6/13
Y1 - 2013/6/13
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.
AB - 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.
KW - Child psychiatry
KW - Delirium
KW - Pediatric critical care
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U2 - 10.1017/S1478951514000212
DO - 10.1017/S1478951514000212
M3 - Article
C2 - 24762563
AN - SCOPUS:84945481317
VL - 13
SP - 513
EP - 516
JO - Palliative and Supportive Care
JF - Palliative and Supportive Care
SN - 1478-9515
IS - 3
ER -