e‐Screening revolution: A novel approach to developing a delirium screening tool in the intensive care unit

Eeles, Eamonn; Gunn, Hayley; Sutt, Anna‐Liisa; Pinsker, Donna; Flaws, Dylan; Jarrett, Paul; Lye, India

doi:10.1111/ajag.12525

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…13 Despite this limitation, it should be acknowledged that consumer engagement has been sought in earlier phases of development of the original tool. 1,3 The revised pictorial questions are currently being reviewed against Color Universal Design principles and some changes in the semantics of in-app diagnosis are being eveluated. 14 In the optimised form, clinical testing is anticipated.…”

Section: Number Of Itemsmentioning

confidence: 99%

“…Our group developed an electronic delirium screening tool (eDIS-ICU) designed for use in the intensive care setting. 1 Comprised of multiple questions that relate to delirium diagnostic criteria, eDIS-ICU is designed to select at random a small number of these to the patient. Repeated incorrect responses then default to an in-appgenerated diagnosis of delirium.…”

Section: Introductionmentioning

confidence: 99%

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Face and content validity of a mobile delirium screening tool adapted for use in the medical setting (eDIS‐MED): Welcome to the machine

Eeles,

Tronstad,

Teodorczuk

et al. 2024

Australas J Ageing

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ObjectivesFollowing a user‐centred redesign and refinement process of an electronic delirium screening tool (eDIS‐MED), further accuracy assessment was performed prior to anticipated testing in the clinical setting.MethodsContent validity of each of the existing questions was evaluated by an expert group in the domains of clarity, relevance and importance. Questions with a Content Validity Index (CVI) <0.80 were reviewed by the development group for potential revision. Items with CVI <0.70 were discarded. Next, face validity of the entirety of the tests was conducted and readability measured.ResultsA panel of five clinical experts evaluated the test battery comprising eDIS‐MED. The content validity process endorsed 61 items. The overall scale CVI was 0.92. Eighty‐eight per cent of the responses with regard to question relevancy, usefulness and appropriateness were positive. The questions were deemed fifth grade level and very easy to read.ConclusionsA revised electronic screening tool was shown to be accurate according to an expert group. A clinical validation study is planned.

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Section: Number Of Itemsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Face and content validity of a mobile delirium screening tool adapted for use in the medical setting (eDIS‐MED): Welcome to the machine

Eeles,

Tronstad,

Teodorczuk

et al. 2024

Australas J Ageing

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“…5 For these reasons, authors EE, OT, DF and and a multidisciplinary research group (Critical Care Research Group) have previously developed an electronic delirium screening tool [eDIS-ICU] that we successfully tested in the intensive care setting. 6,7 eDIS-ICU incorporates user-centred, delirium-specific and technological advantages. Firstly, a large bank of potential questions is randomised after each test, thus avoiding re-test error.…”

Section: Introductionmentioning

confidence: 99%

Adaptation of an electronic delirium screening tool for use in the medical setting based on a human centered design approach

Eeles

Tronstad

Flaws

et al. 2023

Delirium Communications

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Background Delirium is frequently missed in clinical practice. We used a user-centred redesign process to evaluate and adapt an existing electronic delirium screening tool (eDIS-ICU) for use in the medical setting. Methods In phase 1, we conducted a brainstorming session to establish context for delirium screening tools in medicine. In phase 2, a pluralistic walkthrough of eDIS-ICU was performed to identify prospective usability in the medical setting. We then extracted positive and negative qualities of eDIS-ICU. In phase 3, recommendations for change were made. Results Pluralistic walkthrough highlighted that eDIS-ICU related to the key groups of functionality, diagnosis, links with management and potential integration with clinical information. Recommended changes to make eDIS-ICU suitable for use in a medical setting included the need for skip function, prior instructions and streamlined testing. Conclusion A human-centred redesign created a pilot electronic delirium screening tool for use in a general medical setting (eDIS-MED).

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“…In response to this common and serious challenge, we designed an algorithm that would capture the representative and multifactorial cause(s) of delirium that could be used to identify clinical causes within a medical setting. The Aetiology in Delirium -Diagnostic Support Tool (AiD-DST) algorithm was developed from first principles by a multiprofessional team with a track record of innovation and cognitive tool development in delirium [13][14][15] (see appendix 1). The algorithm intended to follow the clinical flow of assessment by the physician, capture common causes with the greatest yield and use Bayesian principles of probability to improve efficiency.…”

Section: Introductionmentioning

confidence: 99%

Pilot testing of a new electronic diagnostic support tool (AiD-DST) designed to identify the cause(s) of delirium

Eeles

Worthy

Teodorczuk

et al. 2022

Delirium Communications

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Introduction Delirium is frequently multifactorial, and causes are often missed in clinical practice. The Aetiology in Delirium - Diagnostic Support Tool (AiD-DST) was developed to improve recognition of the causes. We undertook an evaluation of an electronic version of AiD-DST. Methods A development and evaluation life cycle of improvement was used. In phase 1, alpha testing among the development group evaluated technical performance of AiD-DST. In phase 2, we performed a cycle of beta testing among junior doctors to assess impressions of AiD-DST using Think Aloud methodology. We grouped responses into themes and made changes to AiD-DST by the development group accordingly. In phase 3, usability and acceptance of AiD-DST was assessed using the mHealth App Usability Questionnaire (MAUQ). Results In phase 1, software issues were identified, and modifications made. In phase 2, feedback was obtained from 29 junior doctors. Three cycles of feedback were obtained. The number of items identified after each cycle were 20, 12 and 7, respectively. Content was grouped into themes of; ‘style and grammar’, ‘formatting’, ‘IT’, ‘missed diagnosis’ and ‘other concerns.’ In phase 3, 20 participants completed MAUQ questionnaire. Overall, the average score was 6.36 (SD=0.8) with 7 as the highest attainable score. This translates to agreement up to strong agreement concerning usability of AiD-DST. Conclusion After a process of optimisation, AiD-DST has been shown to be a usable and potentially useful diagnostic support tool to help junior doctors identify cause(s) of delirium. An implementation study is planned.

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e‐Screening revolution: A novel approach to developing a delirium screening tool in the intensive care unit

Abstract: e-Screening for delirium requires a novel approach to instrument design but may revolutionise recognition of delirium in ICU.

Cited by 9 publications

References 12 publications

Face and content validity of a mobile delirium screening tool adapted for use in the medical setting (eDIS‐MED): Welcome to the machine

Face and content validity of a mobile delirium screening tool adapted for use in the medical setting (eDIS‐MED): Welcome to the machine

Adaptation of an electronic delirium screening tool for use in the medical setting based on a human centered design approach

Pilot testing of a new electronic diagnostic support tool (AiD-DST) designed to identify the cause(s) of delirium

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