Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer

Elisabeth C.W. Neefjes, Maurice J.D.L. Van Der Vorst, Manon S.A. Boddaert, Bea A.T.T. Verdegaal, Aart Beeker, Saskia C.C. Teunissen, Aartjan T.F. Beekman, Wouter W.A. Zuurmond, Johannes Berkhof, Henk M.W. Verheul

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The Delirium Observation Screening Scale (DOS) was developed to facilitate early recognition of delirium by nurses during routine clinical care. It has shown good validity in a variety of patient populations, but has not yet been validated in hospitalized patients with advanced cancer, although the DOS is commonly used in this setting in daily practice. The aim of this study was to evaluate the accuracy of the DOS in hospitalized patients with advanced cancer using the revised version of the Delirium Rating Scale (DRS-R- 98) as the gold standard. Methods: Patients with advanced cancer admitted to the medical oncology ward were screened for delirium with the DOS and DRS-R-98. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the DOS were calculated, using a DOS score ≥ 3 as a cut-off for delirium. Results: Ninety-five DOS negative and 98 DOS positive patients were identified. Sensitivity of the DOS, was > 99.9% (95%-CI, 95.8-100.0%), specificity was 99.5% (95%-CI 95.5-99.96%), PPV was 94.6% (95% CI 88.0-97.7), and NPV was > 99.9% (95% CI 96.1-100.0). Conclusions: The DOS is an accurate screening tool for delirium in patients with advanced cancer. Since it has the benefit of being easily implicated in daily practice, we recommend to educate caregivers to screen patients with advanced cancer by DOS analysis. By early recognition and adequate treatment of this distressing delirium syndrome the quality of life of patients with advanced cancer can be improved. Trial registration: ClinicalTrials.gov Identifier NCT01539733 (Feb 27, 2012 - retrospectively registered), Netherlands Trial Register NTR2559 (Oct 7, 2010).

Original languageEnglish
Article number160
JournalBMC Cancer
Volume19
Issue number1
DOIs
Publication statusPublished - 19 Feb 2019

Cite this

@article{0abb3c570f28485eab3e70641f32b079,
title = "Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer",
abstract = "Background: The Delirium Observation Screening Scale (DOS) was developed to facilitate early recognition of delirium by nurses during routine clinical care. It has shown good validity in a variety of patient populations, but has not yet been validated in hospitalized patients with advanced cancer, although the DOS is commonly used in this setting in daily practice. The aim of this study was to evaluate the accuracy of the DOS in hospitalized patients with advanced cancer using the revised version of the Delirium Rating Scale (DRS-R- 98) as the gold standard. Methods: Patients with advanced cancer admitted to the medical oncology ward were screened for delirium with the DOS and DRS-R-98. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the DOS were calculated, using a DOS score ≥ 3 as a cut-off for delirium. Results: Ninety-five DOS negative and 98 DOS positive patients were identified. Sensitivity of the DOS, was > 99.9{\%} (95{\%}-CI, 95.8-100.0{\%}), specificity was 99.5{\%} (95{\%}-CI 95.5-99.96{\%}), PPV was 94.6{\%} (95{\%} CI 88.0-97.7), and NPV was > 99.9{\%} (95{\%} CI 96.1-100.0). Conclusions: The DOS is an accurate screening tool for delirium in patients with advanced cancer. Since it has the benefit of being easily implicated in daily practice, we recommend to educate caregivers to screen patients with advanced cancer by DOS analysis. By early recognition and adequate treatment of this distressing delirium syndrome the quality of life of patients with advanced cancer can be improved. Trial registration: ClinicalTrials.gov Identifier NCT01539733 (Feb 27, 2012 - retrospectively registered), Netherlands Trial Register NTR2559 (Oct 7, 2010).",
keywords = "Delirium, Diagnosis, Neoplasms, Palliative care, Validation studies",
author = "Neefjes, {Elisabeth C.W.} and {Van Der Vorst}, {Maurice J.D.L.} and Boddaert, {Manon S.A.} and Verdegaal, {Bea A.T.T.} and Aart Beeker and Teunissen, {Saskia C.C.} and Beekman, {Aartjan T.F.} and Zuurmond, {Wouter W.A.} and Johannes Berkhof and Verheul, {Henk M.W.}",
year = "2019",
month = "2",
day = "19",
doi = "10.1186/s12885-019-5351-8",
language = "English",
volume = "19",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",
number = "1",

}

Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. / Neefjes, Elisabeth C.W.; Van Der Vorst, Maurice J.D.L.; Boddaert, Manon S.A.; Verdegaal, Bea A.T.T.; Beeker, Aart; Teunissen, Saskia C.C.; Beekman, Aartjan T.F.; Zuurmond, Wouter W.A.; Berkhof, Johannes; Verheul, Henk M.W.

In: BMC Cancer, Vol. 19, No. 1, 160, 19.02.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer

AU - Neefjes, Elisabeth C.W.

AU - Van Der Vorst, Maurice J.D.L.

AU - Boddaert, Manon S.A.

AU - Verdegaal, Bea A.T.T.

AU - Beeker, Aart

AU - Teunissen, Saskia C.C.

AU - Beekman, Aartjan T.F.

AU - Zuurmond, Wouter W.A.

AU - Berkhof, Johannes

AU - Verheul, Henk M.W.

PY - 2019/2/19

Y1 - 2019/2/19

N2 - Background: The Delirium Observation Screening Scale (DOS) was developed to facilitate early recognition of delirium by nurses during routine clinical care. It has shown good validity in a variety of patient populations, but has not yet been validated in hospitalized patients with advanced cancer, although the DOS is commonly used in this setting in daily practice. The aim of this study was to evaluate the accuracy of the DOS in hospitalized patients with advanced cancer using the revised version of the Delirium Rating Scale (DRS-R- 98) as the gold standard. Methods: Patients with advanced cancer admitted to the medical oncology ward were screened for delirium with the DOS and DRS-R-98. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the DOS were calculated, using a DOS score ≥ 3 as a cut-off for delirium. Results: Ninety-five DOS negative and 98 DOS positive patients were identified. Sensitivity of the DOS, was > 99.9% (95%-CI, 95.8-100.0%), specificity was 99.5% (95%-CI 95.5-99.96%), PPV was 94.6% (95% CI 88.0-97.7), and NPV was > 99.9% (95% CI 96.1-100.0). Conclusions: The DOS is an accurate screening tool for delirium in patients with advanced cancer. Since it has the benefit of being easily implicated in daily practice, we recommend to educate caregivers to screen patients with advanced cancer by DOS analysis. By early recognition and adequate treatment of this distressing delirium syndrome the quality of life of patients with advanced cancer can be improved. Trial registration: ClinicalTrials.gov Identifier NCT01539733 (Feb 27, 2012 - retrospectively registered), Netherlands Trial Register NTR2559 (Oct 7, 2010).

AB - Background: The Delirium Observation Screening Scale (DOS) was developed to facilitate early recognition of delirium by nurses during routine clinical care. It has shown good validity in a variety of patient populations, but has not yet been validated in hospitalized patients with advanced cancer, although the DOS is commonly used in this setting in daily practice. The aim of this study was to evaluate the accuracy of the DOS in hospitalized patients with advanced cancer using the revised version of the Delirium Rating Scale (DRS-R- 98) as the gold standard. Methods: Patients with advanced cancer admitted to the medical oncology ward were screened for delirium with the DOS and DRS-R-98. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the DOS were calculated, using a DOS score ≥ 3 as a cut-off for delirium. Results: Ninety-five DOS negative and 98 DOS positive patients were identified. Sensitivity of the DOS, was > 99.9% (95%-CI, 95.8-100.0%), specificity was 99.5% (95%-CI 95.5-99.96%), PPV was 94.6% (95% CI 88.0-97.7), and NPV was > 99.9% (95% CI 96.1-100.0). Conclusions: The DOS is an accurate screening tool for delirium in patients with advanced cancer. Since it has the benefit of being easily implicated in daily practice, we recommend to educate caregivers to screen patients with advanced cancer by DOS analysis. By early recognition and adequate treatment of this distressing delirium syndrome the quality of life of patients with advanced cancer can be improved. Trial registration: ClinicalTrials.gov Identifier NCT01539733 (Feb 27, 2012 - retrospectively registered), Netherlands Trial Register NTR2559 (Oct 7, 2010).

KW - Delirium

KW - Diagnosis

KW - Neoplasms

KW - Palliative care

KW - Validation studies

UR - http://www.scopus.com/inward/record.url?scp=85061866971&partnerID=8YFLogxK

U2 - 10.1186/s12885-019-5351-8

DO - 10.1186/s12885-019-5351-8

M3 - Article

VL - 19

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 160

ER -