Accuracy of Delirium Screening Tools in Older People with Cancer-A Systematic Review

first_pageDownload PDFsettingsOrder Article Reprints Open AccessReview Accuracy of Delirium Screening Tools in Older People with Cancer¿A Systematic Review by Francisco Miguel Martínez-Arnau 1,2ORCID,Andrea Puchades-García 3 andPilar Pérez-Ros 2,3,*ORCID 1 Department of Physiotherapy, Universitat de València, Gascó Oliag 5, 46010 Valencia, Spain 2 Frailty and Cognitive Impairment Research Group (FROG), Universitat de València, Menendez Pelayo s/n, 46010 Valencia, Spain 3 Department of Nursing, Faculty of Nursing and Podiatry, Universitat de València, Menendez Pelayo s/n, 46010 Valencia, Spain * Author to whom correspondence should be addressed. Cancers 2023, 15(10), 2807; https://doi.org/10.3390/cancers15102807 Submission received: 9 April 2023 / Revised: 15 May 2023 / Accepted: 16 May 2023 / Published: 17 May 2023 (This article belongs to the Special Issue Current Challenges in Geriatric Oncology) Downloadkeyboard_arrow_down Browse Figures Review Reports Versions Notes Simple Summary One of the main complications of cancer is delirium, especially in advanced stages. Our aim is to determine which delirium screening instrument is the most accurate in older people with cancer. A systematic review was performed on 13 different assessment tools, reporting an incidence of delirium ranging from 14.3% to 68.3%. The Delirium Observation Screening Scale (DOSS) showed the best metric properties, followed by the Nursing Delirium Screening Scale (NuDESC), Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Screening tools for delirium are heterogeneous, and there is a need to analyze metric properties exclusively in the older population as knowing the tools with the greatest diagnostic accuracy will enable physicians and nurses to make the correct choice for early detection of delirium. In this way, the most appropriate measures could be implemented to avoid harmful consequences. Abstract Background: The increase in life expectancy worldwide has led to a larger population of older people, which in turn entails a rising prevalence of cancer. One of the main complications of cancer is delirium, especially in advanced stages. Objective: To determine which delirium screening instrument is the most accurate in older people with cancer. Methods: A systematic review was designed. A literature search was performed in MEDLINE, EBSCO and SCOPUS; additional records were identified by handsearching. Selection criteria were studies involving people with cancer and a mean sample age of 60 years or older, assessing delirium, and reporting the metric properties of the assessment instrument. Studies with post-surgical patients and substance abuse delirium were excluded. Results: From 2001 to 2021, 14 eligible studies evaluated 13 different assessment tools, reporting an incidence of delirium ranging from 14.3% to 68.3%. The Delirium Observation Screening Scale (DOSS) showed the best metric properties, followed by the Nursing Delirium Screening Scale (NuDESC), Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Only two studies were considered to be at low risk of bias using the QUADAS-2 Tool. No study exclusively examined this population group. Conclusions: Screening tools for delirium are heterogeneous for older people with cancer, and there is a need to analyze metric properties exclusively in the older population. Registered on PROSPERO ID: CRD42022303530. Keywords: cancer; aged; delirium; assessment; accuracy; psychometric properties; incidence; prevalence