The validity and reliability of the Chinese version of 3D-CAM for the detection of delirium in the elderly

Abstract

Objective To translate the 3-minute diagnostic confusion assessment method(3D-CAM)into Chinese, to revise it, and to test its reliability and validity in elderly patients. Methods We translated and culturally adapted 3D-CAM into Chinese.The sample was formed by 230 elderly patients over 65 years of age.We tested inter-assessors reliability and criterion validity(diagnostic validity)and then computed the sensitivity, specificity, positive predictive value, and negative predictive value of the Chinese version of 3D-CAM. Results Correlation analyses between each item and its total score showed that the correlation coefficients ranged between 0.290 and 0.724, all reaching statistical significance(P<0.01). Inter-assessor reliability in a sample size of 30 patients resulted in a kappa value of 0.78(P<0.001). Compared with the gold standard, the diagnostic and statistical manual of mental disorders(DSM-5)by American Psychiatric Association(APA), the sensitivity of the Chinese version of 3D-CAM was 94.73%, the specificity was 97.92%, the positive predictive value was 90.00%, and the negative predictive value was 98.95%. Conclusions The Chinese version of 3D-CAM has achieved satisfactory reliability and validity through pilot runs in surgery and internal medicine inpatients, proved to be easy and convenient to administer, and can be used as an assessment tool for delirium in elderly surgery and internal medicine patients. Key words: Delirium; Validity; Reliability; Chinese Version of 3D-CAM