DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study

Fienke L. Ditzel*, Suzanne C.A. Hut, Mark van den Boogaard, Michel Boonstra, Frans S.S. Leijten, Evert Jan Wils, Tim van Nesselrooij, Marjan Kromkamp, Paul J.T. Rood, Christian Röder, Paul F. Bouvy, Michiel Coesmans, Robert Jan Osse, Monica Pop-Purceleanu, Edwin van Dellen, Jaap W.M. Krulder, Koen Milisen, Richard Faaij, Ariël M. Vondeling, Ad M. KamperBarbara C. van Munster, Annemarieke de Jonghe, Marian A.M. Winters, Jeanette van der Ploeg, Sanneke van der Zwaag, Dineke H.L. Koek, Clara A.C. Drenth-van Maanen, Albertus Beishuizen, Deirdre M. van den Bos, Wiepke Cahn, Ewoud Schuit, Arjen J.C. Slooter

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Objectives: To measure the diagnostic accuracy of DeltaScan: a portable real-time brain state monitor for identifying delirium, a manifestation of acute encephalopathy (AE) detectable by polymorphic delta activity (PDA) in single-channel electroencephalograms (EEGs). 

Design: Prospective cross-sectional study. 

Setting: Six Intensive Care Units (ICU's) and 17 non-ICU departments, including a psychiatric department across 10 Dutch hospitals. 

Participants: 494 patients, median age 75 (IQR:64-87), 53% male, 46% in ICUs, 29% delirious. 

Measurements: DeltaScan recorded 4-minute EEGs, using an algorithm to select the first 96 seconds of artifact-free data for PDA detection. This algorithm was trained and calibrated on two independent datasets. 

Methods: Initial validation of the algorithm for AE involved comparing its output with an expert EEG panel's visual inspection. The primary objective was to assess DeltaScan's accuracy in identifying delirium against a delirium expert panel's consensus. 

Results: DeltaScan had a 99% success rate, rejecting 6 of the 494 EEG's due to artifacts. Performance showed and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.86 (95% CI: 0.83-0.90) for AE (sensitivity: 0.75, 95%CI=0.68-0.81, specificity: 0.87 95%CI=0.83-0.91. The AUC was 0.71 for delirium (95%CI=0.66-0.75, sensitivity: 0.61 95%CI=0.52-0.69, specificity: 72, 95%CI=0.67-0.77). Our validation aim was an NPV for delirium above 0.80 which proved to be 0.82 (95%CI: 0.77-0.86). Among 84 non-delirious psychiatric patients, DeltaScan differentiated delirium from other disorders with a 94% (95%CI: 87-98%) specificity. 

Conclusions: DeltaScan can diagnose AE at bedside and shows a clear relationship with clinical delirium. Further research is required to explore its role in predicting delirium-related outcomes.

Originele taal-2English
Aantal pagina's12
TijdschriftAmerican Journal of Geriatric Psychiatry
Vroegere onlinedatum9-dec.-2023
DOI's
StatusPublished - 2024

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