Diagnostic Accuracy of the 4AT for Delirium: A Systematic Review and Meta-Analysis
Asian Journal of Psychiatry
Hou, L., Zhang, Q., et al. (2023).
Asian Journal of Psychiatry, 80, 103374.
<div>This systematic review and meta-analysis explores the diagnostic accuracy of the 4AT for detecting delirium in adults. Of note, although speech-language pathologists (SLPs) do not diagnose delirium, SLPs may administer delirium screening tools as part of a multidisciplinary effort to prevent and manage delirium.</div>
Fundamental Research Funds for the Central Universities (China); China Medical Board Open Project Funding; Special Fund for Soft Science in Gansu Province (China)
From database inception to January 2022
<div>Published cohort and cross-sectional studies</div>
11
<div>Overall, the 4AT demonstrated the following psychometrics when used to identify adults with delirium:</div>
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<ul>
<li>pooled sensitivity: 87% (range = 50.0%-93.3%);</li>
<li>pooled specificity: 87% (range = 64.5%-99.2%);</li>
<li>positive likelihood ratio: 6.66;</li>
<li>negative likelihood ratio: 0.15;</li>
<li>pooled diagnostic odds ratio: 3.77; and</li>
<li>area under the curve: 0.93.</li>
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<div>Patient setting impacted diagnostic accuracy, with improved accuracy in emergency room (sensitivity = 87%, specificity = 93%) versus inpatient settings (sensitivity = 86%, specificity = 85%).</div>
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<div>Limitations to this review include a small number of included studies and differences between studies (i.e., patient characteristics, settings, diagnostic criteria).</div>
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