The Delirium Observation Screening Scale: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

Abstract

Delirium is a reversible impairment of metabolism in the human brain. Early detection is important, and an effective screening tool for nurses is crucial. The Delirium Observation Screening (DOS) scale is one such screening tool; however, its diagnostic test accuracy has not yet been thoroughly examined. This study, therefore, aimed to evaluate the accuracy of the scale through a systematic review and meta-analysis. In July 2019, a search was conducted in the MEDLINE, CINAHL, Embase, and PsycARTICLES databases, and following a review against pre-defined eligibility criteria, eight studies were finally included. The quality assessment tool of diagnostic accuracy studies was applied to each study and a hierarchical regression model was used to calculate the pooled estimates of sensitivity (90%; 76%–97%, CI 95%) and specificity (92%; 88%–94%, CI 95%). The findings indicated a high diagnostic test accuracy for the DOS scale.

Evaluation of the association of anticholinergic burden and delirium in older hospitalised patients – A cohort study comparing 19 anticholinergic burden scales

“…[54][55][56] 57 its sensitivity and specificity of 90% and 92%, respectively, is high. 58 This is comparable to the CAM (diagnostic tool), which has a sensitivity of 82% and a specificity of 99%. 59 Considering only ICD-10 diagnosis codes and the CAM, our delirium rate would have dropped to 3.3%, which is below the reported range of 6% to 56%.…”

“…At our hospital nurses assess the DOSS three times a day and, if the daily mean is equal to or larger than three points, a physician should confirm the diagnosis by performing the CAM. Even though the DOSS is considered only a screening tool, 57 its sensitivity and specificity of 90% and 92%, respectively, is high 58 . This is comparable to the CAM (diagnostic tool), which has a sensitivity of 82% and a specificity of 99% 59 .…”

Does Comprehensive Geriatric Assessment Reduce the Incidence of Postoperative Delirium? A Quasi-experimental Study in Older Adults Undergoing Transcatheter Aortic Valve Implantation

“…The DOS is a validated tool for the diagnosis of delirium with expanding use in various clinical settings showing a pooled sensitivity and specificity of 90% and 92% (95%CI: 76–97 and 88–94), respectively, and has the advantage of being easily integrated in routine nursing care. 23 For our study, presence of POD was defined as a score of ≥3 points in the Delirium Observation Screening Scale (DOS) or ≥4 points in the Intensive Care Delirium Screening Checklist (ICDSC).…”

The association between the inflammatory response following surgery and post-operative delirium in older oncological patients: a prospective cohort study

“…POD was diagnosed during hospital admission by ward physicians, geriatricians or psychiatrists and registered in the Electronic Medical Record (EMR). For more than 10 years, the DOS scale is a frequently used and accurate screening tool for early recognition of delirium with a sensitivity of 90% and a specificity of 92% [ 22 , 23 ].…”