Korean Version of the Delirium Rating Scale-Revised-98: Reliability and Validity

Abstract

ObjectiveThe aims of the present study were 1) to standardize the validity and reliability of the Korean version of Delirium Rating Scale-Revised-98 (DRS-R98-K) and 2) to establish the optimum cut-off value, sensitivity, and specificity for discriminating delirium from other non-delirious psychiatric conditions.MethodsUsing DSM-IV criteria, 157 subjects (69 delirium, 29 dementia, 32 schizophrenia, and 27 other psychiatric patients) were enrolled. Subjects were evaluated using DRS-R98-K, DRS-K, Mini-Mental State Examination (MMSE-K), and Clinical Global Impression-Severity (CGI-S) scale.ResultsDRS-R98-K total and severity scores showed high correlations with DRS-K. They were significantly different across all groups (p=0.000). However, neither MMSE-K nor CGI-S distinguished delirium from dementia. All DRS-R98-K diagnostic items (#14-16) and items #1 and 2 significantly discriminated delirium from dementia. Cronbach's alpha coefficient revealed high internal consistency for DRS-R98-K total (r=0.91) and severity (r=0.89) scales. Interrater reliability (ICC between 0.96 and 1) was very high. Using receiver operating characteristic analysis, the area under the curve of DRS-R98-K total score was 0.948 between the delirium group and all other groups and 0.873 between the delirium and dementia groups. The best cut-off scores in DRS-R98-K total score were 18.5 and 19.5 between the delirium and the other three groups and 20.5 between the delirium and dementia groups.ConclusionWe demonstrated that DRS-R98-K is a valid and reliable instrument for assessing delirium severity and diagnosis and discriminating delirium from dementia and other psychiatric disorders in Korean patients.

Phenotype of subsyndromal delirium using pooled multicultural Delirium Rating Scale—Revised-98 data

“…It has been subsequently translated and revalidated in countries outside of the U.S. Translations were used, as appropriate, and raters had been trained as part of individual projects. The DRS-R98 versions used had very high inter-rater reliability (intraclass correlation coefficient >0.9), and excellent validity as shown by the area under the curve >0.9 (Receiver-Operator Characteristic analyses) when comparing DSM Delirium vs. Non-delirium patients for all DRS-R98 versions utilized in this study [13,14,16,17,19,21,22]. The DRS-R98 broadly measures delirium phenomenology using anchored item descriptors and has been validated against other neuropsychiatric disorders making it an ideal instrument to assess phenomenology.…”

“…De-identified cross-sectional data for adult patients from 14 studies (11 of them published) conducted by expert delirium researchers in 7 countries (United States, Brazil, Colombia, Ireland, Taiwan, Korea and Japan) from 4 continents comprised the pooled database (see Supplemental Table 1S) [13][14][15][16][17][18][19][20][21][22][23]. Investigators were invited by Dr. Trzepacz, the developer of the DRS-R98, to participate in this study because they had previously received permission to use the scale for work related to its validation.…”

A personality trait contributes to the occurrence of postoperative delirium: a prospective study

“…By a trained psychiatrist, diagnosis of delirium was made using the CAM, and the severity of delirium in cognitive and non-cognitive items was assessed using Korean-Delirium Rating Scale-R-98 (K-DRS) [24]. These measures for delirium were made for 7 days at intervals of 24 h. To measure cognitive decline during delirium, we used the MMSE on the delirium onset day.…”

Instrumentos para el diagnóstico de delirium en hispanohablantes: artículo de revisión

“…En todos los estudios en los que se ha evaluado la sensibilidad al cambio (diferencia de medias de puntuación), la p del estadístico t ha sido <0.05 [64][65][66][67][68][69] . El punto de corte ≥12 tiene sensibilidad de 82.4% y especificidad de 95.7% para el diagnóstico de delirium (versión colombiana) 64 .…”