TY - JOUR
T1 - DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study
AU - Ditzel, Fienke L
AU - Hut, Suzanne C A
AU - van den Boogaard, Mark
AU - Boonstra, Michel
AU - Leijten, Frans S S
AU - Wils, Evert-Jan
AU - van Nesselrooij, Tim
AU - Kromkamp, Marjan
AU - Rood, Paul J T
AU - Röder, Christian
AU - Bouvy, Paul F
AU - Coesmans, Michiel
AU - Osse, Robert Jan
AU - Pop-Purceleanu, Monica
AU - van Dellen, Edwin
AU - Krulder, Jaap W M
AU - Milisen, Koen
AU - Faaij, Richard
AU - Vondeling, Ariël M
AU - Kamper, Ad M
AU - van Munster, Barbara C
AU - de Jonghe, Annemarieke
AU - Winters, Marian A M
AU - van der Ploeg, Jeanette
AU - van der Zwaag, Sanneke
AU - Koek, Dineke H L
AU - Drenth-van Maanen, Clara A C
AU - Beishuizen, Albertus
AU - van den Bos, Deirdre M
AU - Cahn, Wiepke
AU - Schuit, Ewoud
AU - Slooter, Arjen J C
N1 - Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2024/9
Y1 - 2024/9
N2 - OBJECTIVES: To measure the diagnostic accuracy of DeltaScan: a portable real-time brain state monitor for identifying delirium, a manifestation of acute encephalopathy (AE) detectable by polymorphic delta activity (PDA) in single-channel electroencephalograms (EEGs).DESIGN: Prospective cross-sectional study.SETTING: Six Intensive Care Units (ICU's) and 17 non-ICU departments, including a psychiatric department across 10 Dutch hospitals.PARTICIPANTS: 494 patients, median age 75 (IQR:64-87), 53% male, 46% in ICUs, 29% delirious.MEASUREMENTS: DeltaScan recorded 4-minute EEGs, using an algorithm to select the first 96 seconds of artifact-free data for PDA detection. This algorithm was trained and calibrated on two independent datasets.METHODS: Initial validation of the algorithm for AE involved comparing its output with an expert EEG panel's visual inspection. The primary objective was to assess DeltaScan's accuracy in identifying delirium against a delirium expert panel's consensus.RESULTS: DeltaScan had a 99% success rate, rejecting 6 of the 494 EEG's due to artifacts. Performance showed and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.86 (95% CI: 0.83-0.90) for AE (sensitivity: 0.75, 95%CI=0.68-0.81, specificity: 0.87 95%CI=0.83-0.91. The AUC was 0.71 for delirium (95%CI=0.66-0.75, sensitivity: 0.61 95%CI=0.52-0.69, specificity: 72, 95%CI=0.67-0.77). Our validation aim was an NPV for delirium above 0.80 which proved to be 0.82 (95%CI: 0.77-0.86). Among 84 non-delirious psychiatric patients, DeltaScan differentiated delirium from other disorders with a 94% (95%CI: 87-98%) specificity.CONCLUSIONS: DeltaScan can diagnose AE at bedside and shows a clear relationship with clinical delirium. Further research is required to explore its role in predicting delirium-related outcomes.
AB - OBJECTIVES: To measure the diagnostic accuracy of DeltaScan: a portable real-time brain state monitor for identifying delirium, a manifestation of acute encephalopathy (AE) detectable by polymorphic delta activity (PDA) in single-channel electroencephalograms (EEGs).DESIGN: Prospective cross-sectional study.SETTING: Six Intensive Care Units (ICU's) and 17 non-ICU departments, including a psychiatric department across 10 Dutch hospitals.PARTICIPANTS: 494 patients, median age 75 (IQR:64-87), 53% male, 46% in ICUs, 29% delirious.MEASUREMENTS: DeltaScan recorded 4-minute EEGs, using an algorithm to select the first 96 seconds of artifact-free data for PDA detection. This algorithm was trained and calibrated on two independent datasets.METHODS: Initial validation of the algorithm for AE involved comparing its output with an expert EEG panel's visual inspection. The primary objective was to assess DeltaScan's accuracy in identifying delirium against a delirium expert panel's consensus.RESULTS: DeltaScan had a 99% success rate, rejecting 6 of the 494 EEG's due to artifacts. Performance showed and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.86 (95% CI: 0.83-0.90) for AE (sensitivity: 0.75, 95%CI=0.68-0.81, specificity: 0.87 95%CI=0.83-0.91. The AUC was 0.71 for delirium (95%CI=0.66-0.75, sensitivity: 0.61 95%CI=0.52-0.69, specificity: 72, 95%CI=0.67-0.77). Our validation aim was an NPV for delirium above 0.80 which proved to be 0.82 (95%CI: 0.77-0.86). Among 84 non-delirious psychiatric patients, DeltaScan differentiated delirium from other disorders with a 94% (95%CI: 87-98%) specificity.CONCLUSIONS: DeltaScan can diagnose AE at bedside and shows a clear relationship with clinical delirium. Further research is required to explore its role in predicting delirium-related outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85182454048&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2023.12.005
DO - 10.1016/j.jagp.2023.12.005
M3 - Article
C2 - 38171949
VL - 32
SP - 1093
EP - 1104
JO - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
SN - 1064-7481
IS - 9
ER -