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The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis.
Mitchell, Alex J; Shukla, Deepak; Ajumal, Hafsa A; Stubbs, Brendon; Tahir, Tayyeb A.
Afiliación
  • Mitchell AJ; Leicester General Hospital, Leicester Partnership Trust, Leicester LE5 4PW, UK. Electronic address: ajm80@le.ac.uk.
  • Shukla D; Leicester General Hospital, Leicester Partnership Trust, Leicester LE5 4PW, UK. Electronic address: Deepak.Shukla@leicspart.nhs.uk.
  • Ajumal HA; University of Leicester, Leicester, UK. Electronic address: haa15@student.le.ac.uk.
  • Stubbs B; University of Greenwich, London, UK. Electronic address: b.stubbs@greenwich.ac.uk.
  • Tahir TA; University Hospital of Wales, Cardiff, UK; Vale University Health Board, Heath Park, Cardiff, UK. Electronic address: tayyeb.tahir@wales.nhs.uk.
Gen Hosp Psychiatry ; 36(6): 627-33, 2014.
Article en En | MEDLINE | ID: mdl-25267696
OBJECTIVE: To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults. METHOD: Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted. RESULTS: Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and 82.8% in a subgroup analysis involving robust high quality studies. Sensitivity was unchanged but specificity was 68.4% (95% CI = 50.9-83.5%) in studies using a predefined cutoff of <24 to signify a case. In high-risk samples where delirium was present in 25% of patients, then the Positive predictive value and Negative predictive value would be 50.9% (48.3-66.2%) and 93.2% (90.0-96.5%). CONCLUSION: The MMSE cannot be recommended as a case-finding confirmatory test of delirium, but may be used as an initial screen to rule out high scorers who are unlikely to have delirium with approximately 93% accuracy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Escala del Estado Mental Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Gen Hosp Psychiatry Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Escala del Estado Mental Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Gen Hosp Psychiatry Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos