Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses
Sanchai Kuladee, Thanavadee Prachason Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity...
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Dove Medical Press
2016
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oai:doaj.org-article:4b17905562954cf6b50f693463db4d662021-12-02T01:55:24ZDevelopment and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses1178-2021https://doaj.org/article/4b17905562954cf6b50f693463db4d662016-02-01T00:00:00Zhttps://www.dovepress.com/development-and-validation-of-the-thai-version-of-the-4-lsquoarsquos-t-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Sanchai Kuladee, Thanavadee Prachason Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity among hospitalized elderly patients.Objective: To develop the Thai version of the 4AT (4AT-T) and assess its validity.Subjects and setting: A total of 97 elderly patients aged 60 years or above who were admitted to the general medical wards were included.Methods: Both authors independently translated the English version of the 4AT into Thai and thereafter developed a single reconciled forward translation by consensus. Back translation was performed by a bilingual native English speaker and it was then reviewed to ensure its agreement with the original one. After 24 hours of admission, subjects were enrolled and clinical data collected. Definite diagnosis of delirium was made by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria and the 6-item Thai Delirium Rating Scale; the 4AT was then administered to participants by nurses within 30 minutes. A 4AT score ≥4 was considered positive for delirium screening. The optimal cut-off point of the 4AT-T was identified by Youden’s index.Results: In all, 24 out of 97 participants met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria for delirium. At a cut-off score of 4 or greater, the 4AT-T exhibited satisfactory diagnostic performance with a sensitivity of 83.3% (95% confidence interval (CI): 62.6%–95.3%) and specificity of 86.3% (95% CI: 76.3%–93.2%). The area under the receiver operating characteristic curve was 0.92. The specified score provided maximal Youden’s index, suggesting an optimal criterion value for delirium screening.Conclusion: The 4AT-T is a valid delirium-screening instrument for hospitalized elderly patients with acute medical illnesses. Keywords: Thai, delirium, screening tool, delirium screening, acute medical illnessesKuladee SPrachason TDove Medical PressarticleThaideliriumscreening tooldelirium screeningacute medical illnessesNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 437-443 (2016) |
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DOAJ |
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DOAJ |
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EN |
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Thai delirium screening tool delirium screening acute medical illnesses Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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Thai delirium screening tool delirium screening acute medical illnesses Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kuladee S Prachason T Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| description |
Sanchai Kuladee, Thanavadee Prachason Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background: The English version of the 4 ‘A’s Test (4AT) is a rapid screening tool for delirium with a high sensitivity and specificity among hospitalized elderly patients.Objective: To develop the Thai version of the 4AT (4AT-T) and assess its validity.Subjects and setting: A total of 97 elderly patients aged 60 years or above who were admitted to the general medical wards were included.Methods: Both authors independently translated the English version of the 4AT into Thai and thereafter developed a single reconciled forward translation by consensus. Back translation was performed by a bilingual native English speaker and it was then reviewed to ensure its agreement with the original one. After 24 hours of admission, subjects were enrolled and clinical data collected. Definite diagnosis of delirium was made by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria and the 6-item Thai Delirium Rating Scale; the 4AT was then administered to participants by nurses within 30 minutes. A 4AT score ≥4 was considered positive for delirium screening. The optimal cut-off point of the 4AT-T was identified by Youden’s index.Results: In all, 24 out of 97 participants met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text-Revision criteria for delirium. At a cut-off score of 4 or greater, the 4AT-T exhibited satisfactory diagnostic performance with a sensitivity of 83.3% (95% confidence interval (CI): 62.6%–95.3%) and specificity of 86.3% (95% CI: 76.3%–93.2%). The area under the receiver operating characteristic curve was 0.92. The specified score provided maximal Youden’s index, suggesting an optimal criterion value for delirium screening.Conclusion: The 4AT-T is a valid delirium-screening instrument for hospitalized elderly patients with acute medical illnesses. Keywords: Thai, delirium, screening tool, delirium screening, acute medical illnesses |
| format |
article |
| author |
Kuladee S Prachason T |
| author_facet |
Kuladee S Prachason T |
| author_sort |
Kuladee S |
| title |
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| title_short |
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| title_full |
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| title_fullStr |
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| title_full_unstemmed |
Development and validation of the Thai version of the 4 ‘A’s Test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| title_sort |
development and validation of the thai version of the 4 ‘a’s test for delirium screening in hospitalized elderly patients with acute medical illnesses |
| publisher |
Dove Medical Press |
| publishDate |
2016 |
| url |
https://doaj.org/article/4b17905562954cf6b50f693463db4d66 |
| work_keys_str_mv |
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