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首页> 外文期刊>BMC Cancer >“SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665)
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“SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665)

机译：“鱿鱼，谵妄中的单一问题; 一个问题可以帮助临床医生检测住院癌症患者的谵妄吗？“ 在谵妄中运行标题单个问题“（Band-20-01665）

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摘要

A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the ‘Single Question in Delirium’ (SQiD), in comparison to psychiatrist clinical interview. Inpatients in two comprehensive cancer centres were prospectively screened. Clinical staff asked informants to respond to the SQiD: “Do you feel that [patient’s name] has been more confused lately?”. The primary endpoint was negative predictive value (NPV) of the?SQiD versus psychiatrist diagnosis (Diagnostic and Statistics Manual criteria). Secondary endpoints included: NPV of the Confusion Assessment Method (CAM), sensitivity, specificity and Cohen’s Kappa coefficient. Between May 2012 and July 2015, the SQiD plus CAM was applied to 122 patients; 73 had the SQiD and psychiatrist interview. Median age was 65?yrs. (interquartile range 54–74), 46% were female; median length of hospital stay was 12?days (5–18?days). Major cancer types were lung (19%), gastric or other upper GI (15%) and breast (14%). 70% of participants had stage 4 cancer. Diagnostic values were similar between the SQiD (NPV?=?74, 95% CI 67–81; kappa?=?0.32) and CAM (NPV?=?72, 95% CI 67–77, kappa?=?0.32), compared with psychiatrist interview. Overall the CAM identified only a small number of delirious cases but all were true positives. The specificity of the SQiD was 87% (74–95) The SQiD had higher sensitivity than CAM (44% [95% CI 41–80] vs 26% [10–48]). The SQiD, administered by bedside clinical staff, was feasible and its psychometric properties are now better understood. The SQiD can contribute to delirium detection and clinical care for hospitalised cancer patients.
机译：癌症患者的严重综合症，谵妄风险随着年龄和医学敏锐而增加。存在筛选工具，但检测经常延迟或错过。与精神科医生临床面试相比，我们测试“谵妄”（SQID）的“单一问题”。两次综合癌症中心的住院患者是潜在的筛查。临床工作人员询问线人回应SQID：“你觉得[病人的名字]最近更加困惑吗？”主要终点是ΔSqid与精神病毒性诊断（诊断和统计手册标准）的负预测值（NPV）。辅助端点包括：混乱评估方法（CAM），敏感度，特异性和Cohen的Kappa系数的NPV。 2012年5月至2015年7月，SQID Plus CAM应用于122名患者; 73有Sqid和精神科医生面试。中位年龄为65岁？YRS。 （四分位于54-74），46％是女性;医院住宿的中位数是12？天（5-18？天）。主要癌症类型是肺（19％），胃或其他上GI（15％）和乳房（14％）。 70％的参与者有4阶段癌症。 SQID之间的诊断值相似（NPV？=α74,95％CI 67-81; Kappa？= 0.32）和凸轮（NPV？=？72,95％CI 67-77，Kappa？= 0.32），与精神科医生面试相比。整体凸轮只确定了少数恶心的病例，但一切都是真正的积极因素。 Sqid的特异性为87％（74-95），Sqid的灵敏度高于凸轮（44％[95％CI 41-80]与26％[10-48]）。由床边临床人员管理的Sqid是可行的，现在更好地了解其心理测量性能。 SQID可以促进住院癌症患者的谵妄检测和临床护理。

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