Diagnostic test accuracy of the Nursing Delirium Screening Scale: A systematic review and meta-analysis

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.