Diagnostic accuracy of the Family Confusion Assessment Method for delirium detection: A systematic review and meta-analysis.
FAM-CAM
caregiver
delirium
family
meta-analysis
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
revised:
03
10
2023
received:
16
06
2023
accepted:
26
10
2023
pubmed:
29
11
2023
medline:
29
11
2023
entrez:
29
11
2023
Statut:
ppublish
Résumé
Delirium is frequently disproportionately under-recognized despite its high prevalence, detrimental impact, and potential lethality. Informant-based delirium detection tools can offer structured assessment and increase the timeliness and frequency of detection. We aimed to examine the diagnostic accuracy of the Family Confusion Assessment Method (FAM-CAM) for delirium detection. We systematically searched the MEDLINE, EMBASE, PsycINFO, CINAHL, CNKI, WANFANG, and SinoMed databases from January 1988 to December 2022. Two reviewers independently screened studies and evaluated methodological quality using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool. A bivariate random effects model was undertaken, and univariable meta-regression was carried out to explore heterogeneity. Seven studies with 483 dyads of participants and family caregivers were identified. Pooled sensitivity and specificity were 0.74 (95% CI: 0.59, 0.86) and 0.91 (95% CI: 0.83, 0.95), respectively, with an area under curve (AUC) of 0.91. The positive likelihood ratio was 8.27 (95% CI: 3.97, 17.25), and the negative likelihood ratio was 0.28 (95% CI: 0.16, 0.50). Settings impacted specificity (p = 0.02). Available evidence indicates that FAM-CAM exhibits moderate sensitivity and high specificity for delirium screening in adults. The FAM-CAM is concise and easy to use, making it appropriate for routine clinical practice, which might benefit early delirium detection and potentially foster delirium management. CRD42022378742.
Sections du résumé
BACKGROUND
BACKGROUND
Delirium is frequently disproportionately under-recognized despite its high prevalence, detrimental impact, and potential lethality. Informant-based delirium detection tools can offer structured assessment and increase the timeliness and frequency of detection. We aimed to examine the diagnostic accuracy of the Family Confusion Assessment Method (FAM-CAM) for delirium detection.
METHODS
METHODS
We systematically searched the MEDLINE, EMBASE, PsycINFO, CINAHL, CNKI, WANFANG, and SinoMed databases from January 1988 to December 2022. Two reviewers independently screened studies and evaluated methodological quality using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool. A bivariate random effects model was undertaken, and univariable meta-regression was carried out to explore heterogeneity.
RESULTS
RESULTS
Seven studies with 483 dyads of participants and family caregivers were identified. Pooled sensitivity and specificity were 0.74 (95% CI: 0.59, 0.86) and 0.91 (95% CI: 0.83, 0.95), respectively, with an area under curve (AUC) of 0.91. The positive likelihood ratio was 8.27 (95% CI: 3.97, 17.25), and the negative likelihood ratio was 0.28 (95% CI: 0.16, 0.50). Settings impacted specificity (p = 0.02).
CONCLUSIONS
CONCLUSIONS
Available evidence indicates that FAM-CAM exhibits moderate sensitivity and high specificity for delirium screening in adults. The FAM-CAM is concise and easy to use, making it appropriate for routine clinical practice, which might benefit early delirium detection and potentially foster delirium management.
PROSPERO REGISTRATION NUMBER
UNASSIGNED
CRD42022378742.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
892-902Subventions
Organisme : 2021 Research Fund of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
ID : 2021D07
Organisme : 2022 Nursing Research Fund (General Project) of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
ID : 2022D19
Organisme : 2023-2024 General Program of Health Commission of Hubei Province
ID : WJ2023M007
Informations de copyright
© 2023 The American Geriatrics Society.
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