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A comparison of the revised Delirium Rating Scale (DRS–R98) and the Memorial Delirium Assessment Scale (MDAS) in a palliative care cohort with DSM–IV delirium

Published online by Cambridge University Press:  03 July 2014

Roisin O'Sullivan ,
David Meagher ,
Maeve Leonard ,
Leiv Otto Watne ,
Roanna J Hall ,
Alasdair M.J. Maclullich ,
Paula Trzepacz  and
Dimitrios Adamis
Roisin O'Sullivan
Affiliation:
Department of Adult Psychiatry, University Hospital Limerick, Limerick, Ireland University of Limerick Medical School, Limerick, Ireland
David Meagher
Affiliation:
Department of Adult Psychiatry, University Hospital Limerick, Limerick, Ireland Cognitive Impairment Research Group, University of Limerick Medical School, Limerick, Ireland University of Limerick Medical School, Limerick, Ireland
Maeve Leonard
Affiliation:
Department of Adult Psychiatry, University Hospital Limerick, Limerick, Ireland Cognitive Impairment Research Group, University of Limerick Medical School, Limerick, Ireland University of Limerick Medical School, Limerick, Ireland
Leiv Otto Watne
Affiliation:
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway University of Oslo, Institute of Clinical Medicine, Norway
Roanna J Hall
Affiliation:
Edinburgh Delirium Research Group, University of Edinburgh, Scotland Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Scotland
Alasdair M.J. Maclullich
Affiliation:
Edinburgh Delirium Research Group, University of Edinburgh, Scotland Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Scotland
Paula Trzepacz
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana Tufts University School of Medicine, Boston, Massachusetts Indiana University School of Medicine, Indianapolis, Indiana
Dimitrios Adamis*
Affiliation:
Cognitive Impairment Research Group, University of Limerick Medical School, Limerick, Ireland University of Limerick Medical School, Limerick, Ireland Sligo Mental Health Services, Sligo, Ireland Research and Academic Institute of Athens, Greece
*
Address correspondence and reprint requests to: Dimitrios Adamis, Sligo Mental Health Services, Clarion Road, Sligo, Ireland. E-mail: [email protected]
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Abstract

Objective:

Assessment of delirium is performed with a variety of instruments, making comparisons between studies difficult. A conversion rule between commonly used instruments would aid such comparisons. The present study aimed to compare the revised Delirium Rating Scale (DRS–R98) and Memorial Delirium Assessment Scale (MDAS) in a palliative care population and derive conversion rules between the two scales.

Method:

Both instruments were employed to assess 77 consecutive patients with DSM–IV delirium, and the measures were repeated at three-day intervals. Conversion rules were derived from the data at initial assessment and tested on subsequent data.

Results:

There was substantial overall agreement between the two scales [concordance correlation coefficient (CCC) = 0.70 (CI95 = 0.60–0.78)] and between most common items (weighted κ ranging from 0.63 to 0.86). Although the two scales overlap considerably, there were some subtle differences with only modest agreement between the attention (weighted κ = 0.42) and thought process (weighted κ = 0.61) items. The conversion rule from total MDAS score to DRS–R98 severity scores demonstrated an almost perfect level of agreement (r = 0.86, CCC = 0.86; CI95 = 0.79–0.91), similar to the conversion rule from DRS–R98 to MDAS.

Significance of results:

Overall, the derived conversion rules demonstrated promising accuracy in this palliative care population, but further testing in other populations is certainly needed.

Keywords

DeliriumDelirium scalesPhenomenologyAssessmentDRS–R98MDASEquation method
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 937 - 944
Copyright
Copyright © Cambridge University Press 2014 

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