Aims: To evaluate the diagnostic test accuracy of the Nursing Delirium Screening Scale through a systematic review and meta-analysis.
Design: A systematic review with meta-analysis.
Data sources: Articles were searched systematically in the MEDLINE, EMBASE, PsycINFO, and CINAHL databases up to April 2019.
Review methods: Data extraction and quality assessment were conducted using the Quality Assessment of the Diagnostic Accuracy Studies-2 tool. Pooled sensitivities, specificities, likelihood ratio, and diagnostic odds ratio for the tool were estimated and its hierarchical summary receiver-operating characteristic curve was derived through a bivariate model meta-analysis.
Results: Eleven studies with a total of 2,245 patients were included in this review. The pooled estimates of sensitivity and specificity of the Nursing Delirium Screening Scale were 68.6% (95% confidence interval; 55.3%, 79.5%) and 89.4% (83.3%, 93.5%), respectively. The pooled estimate of the area under the hierarchical summary receiver-operating characteristic curve was 0.88.
Conclusion: Use of the Nursing Delirium Screening Scale provides moderate to high sensitivity and high specificity. This review supports the Nursing Delirium Screening Scale as a validate tool of screening for delirium.
Impact: With the best evidence of the accuracy of the Nursing Delirium Screening Scale, we recommend nursing leaders to use this easy-to-use and validated tool for daily screening of delirium in any hospital setting, which possibly contribute to an early detection of delirium and, ultimately, assist to obtain an accurate estimation of prevalence of delirium.
目的: 通过系统评估和荟萃分析，对护理谵妄筛查量表的诊断测试准确性进行评估。 设计: 有荟萃分析的系统评估。 数据源: 截至2019年4月，系统在MEDLINE，EMBASE，PsycINFO和CINAHL数据库中系统地搜索文章。 评估方法: 使用诊断准确性研究的质量评价工具2进行数据提取和质量评价。对该工具的敏感性、特异性、似然比和诊断比值比进行评估，并通过双变量模型荟萃分析得出该工具的分层汇总接受者操作特征曲线。 结果: 本综述包括11项研究，共计2,245例患者。护理谵妄筛查量表的敏感性和特异性的汇总估计值分别为68.6％（95％置信区间； 55.3％，79.5％）和89.4％（83.3％，93.5％）。分层汇总接受者操作特征曲线下的区域的汇总估计值为0.88。 结论: 使用护理谵妄筛查量表可提供中等至高灵敏度和高特异性。本综述支持护理谵妄筛查量表作为谵妄筛查的有效工具。 影响: 有了护理谵妄筛查量表准确性的最佳证据，我们建议护理主管在任何医院环境中都使用这种简单且经过验证的工具，对谵妄进行筛查，这可能有助于及早发现谵妄，并且最终，帮助获得谵妄患病率的准确估算。.
Keywords: Nursing Delirium Screening Scale; delirium; meta-analysis; nurses; nursing; sensitivity; specificity; systematic review.
© 2020 John Wiley & Sons Ltd.