Delirium Clinical Trial
Official title:
Validation Study of the 4-question "RACY"Delirium Screening Tool in General Medical In-patients From a Developing Country Setting
Delirium is a serious medical condition associated with increased mortality, longer hospital
stay, increased rates of institutionalisation, and declines in post-admission functionality.
Despite the prognostic utility of diagnosing delirium and its utility as an important
indicator of health quality in elderly patients in developed countries, it is not routinely
screened for in many busy general medical in-patient settings, especially in developing
countries. Unpublished data from a recent study of general medical in-patients in Groote
Schuur Hospital, Cape Town, South Africa, found that no patients admitted during an 8-week
period received any formal cognitive testing or had documentation of the presence/absence of
delirium in routine clinical notes. This under-recognition is largely the result of the
length and complexity of available delirium diagnostic tools e.g. Mini-mental state exam
(MMSE), although the perceived lack of clinical importance and conflicting results about
specific treatment modalities also contribute.
The investigators recently developed the simple 4-question "RACY" delirium screening tool
for use in general medical in-patients. Preliminary data show the test to be simple and
effective with a sensitivity and specificity of 78% and 85% respectively using a
ROC-selected cut-point of RACY≤2. The investigators hypothesis that the RACY screening tool
has the potential to be a simple and effective bedside delirium diagnostic instrument for
use in non-geriatric, busy general medical in-patient settings. This study is a two-centre
validation study to evaluate the diagnostic accuracy of this tool.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Diagnostic
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