Use of an expert panel to identify domains and indicators of delirium severity

BASIL Study Group

Research output: Contribution to journalArticle

Abstract

Purpose: Our purpose was to create a content domain framework for delirium severity to inform item development for a new instrument to measure delirium severity. Methods: We used an established, multi-stage instrument development process during which expert panelists discussed best approaches to measure delirium severity and identified related content domains. We conducted this work as part of the Better ASsessment of ILlness (BASIL) study, a prospective, observational study aimed at developing and testing measures of delirium severity. Our interdisciplinary expert panel consisted of twelve national delirium experts and four expert members of the core research group. Over a one-month period, experts participated in two rounds of review. Results: Experts recommended that the construct of delirium severity should reflect both the phenomena and the impact of delirium to create an accurate, patient-centered instrument useful to interdisciplinary clinicians and family caregivers. Final content domains were Cognitive, Level of consciousness, Inattention, Psychiatric-Behavioral, Emotional dysregulation, Psychomotor features, and Functional. Themes debated by experts included reconciling clinical geriatrics and psychiatric content, mapping symptoms to one specific domain, and accurate capture of unclear clinical presentations. Conclusions: We believe this work represents the first application of instrument development science to delirium. The identified content domains are inclusive of various, wide-ranging domains of delirium severity and are reflective of a consistent framework that relates delirium severity to potential clinical outcomes. Our content domain framework provides a foundation for development of delirium severity instruments that can help improve care and quality of life for patients with delirium.

Original languageEnglish (US)
JournalQuality of Life Research
DOIs
StatePublished - Jan 1 2019

Fingerprint

Delirium
Geriatric Psychiatry
Consciousness
Caregivers
Observational Studies
Psychiatry
Quality of Life
Prospective Studies

Keywords

  • Delirium
  • Expert panel
  • Instrument development
  • Severity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Use of an expert panel to identify domains and indicators of delirium severity. / BASIL Study Group.

In: Quality of Life Research, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Purpose: Our purpose was to create a content domain framework for delirium severity to inform item development for a new instrument to measure delirium severity. Methods: We used an established, multi-stage instrument development process during which expert panelists discussed best approaches to measure delirium severity and identified related content domains. We conducted this work as part of the Better ASsessment of ILlness (BASIL) study, a prospective, observational study aimed at developing and testing measures of delirium severity. Our interdisciplinary expert panel consisted of twelve national delirium experts and four expert members of the core research group. Over a one-month period, experts participated in two rounds of review. Results: Experts recommended that the construct of delirium severity should reflect both the phenomena and the impact of delirium to create an accurate, patient-centered instrument useful to interdisciplinary clinicians and family caregivers. Final content domains were Cognitive, Level of consciousness, Inattention, Psychiatric-Behavioral, Emotional dysregulation, Psychomotor features, and Functional. Themes debated by experts included reconciling clinical geriatrics and psychiatric content, mapping symptoms to one specific domain, and accurate capture of unclear clinical presentations. Conclusions: We believe this work represents the first application of instrument development science to delirium. The identified content domains are inclusive of various, wide-ranging domains of delirium severity and are reflective of a consistent framework that relates delirium severity to potential clinical outcomes. Our content domain framework provides a foundation for development of delirium severity instruments that can help improve care and quality of life for patients with delirium.",
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author = "{BASIL Study Group} and Dena Schulman-Green and Schmitt, {Eva M.} and Fong, {Tamara G.} and Vasunilashorn, {Sarinnapha M.} and Jacqueline Gallagher and Marcantonio, {Edward R.} and Brown, {Charles H.} and Diane Clark and Flaherty, {Joseph H.} and Anne Gleason and Sharon Gordon and Kolanowski, {Ann M.} and Neufeld, {Karin J.} and Margaret O’Connor and Pisani, {Margaret A.} and Robinson, {Thomas N.} and Joe Verghese and Wald, {Heidi L.} and Jones, {Richard N.} and Inouye, {Sharon K.} and Inouye, {Sharon K.} and Jones, {Richard N.} and Sevdenur Cizginer and Fong, {Tamara G.} and Tammy Hshieh and Marcantonio, {Edward R.} and Annie Racine and Schmitt, {Eva M.} and Dena Schulman-Green and Tabloski, {Patricia A.} and Thomas Travison and Tatiana Abrantes and Brett Armstrong and Sylvia Bertrand and Angelee Butters and Madeline D’Aquila and Jacqueline Gallagher and Jennifer Kettell and Jacqueline Nee and Katelyn Parisi and Margaret Vella and Guoquan Xu and Lauren Weiner and Yun Gou and Douglas Tommet and Brown, {Charles H.} and Diane Clark and Flaherty, {Joseph H.} and Anne Gleason and Gordon, {Sharon M.}",
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AU - Gallagher, Jacqueline

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AU - Brown, Charles H.

AU - Clark, Diane

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AU - O’Connor, Margaret

AU - Pisani, Margaret A.

AU - Robinson, Thomas N.

AU - Verghese, Joe

AU - Wald, Heidi L.

AU - Jones, Richard N.

AU - Inouye, Sharon K.

AU - Inouye, Sharon K.

AU - Jones, Richard N.

AU - Cizginer, Sevdenur

AU - Fong, Tamara G.

AU - Hshieh, Tammy

AU - Marcantonio, Edward R.

AU - Racine, Annie

AU - Schmitt, Eva M.

AU - Schulman-Green, Dena

AU - Tabloski, Patricia A.

AU - Travison, Thomas

AU - Abrantes, Tatiana

AU - Armstrong, Brett

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AU - Butters, Angelee

AU - D’Aquila, Madeline

AU - Gallagher, Jacqueline

AU - Kettell, Jennifer

AU - Nee, Jacqueline

AU - Parisi, Katelyn

AU - Vella, Margaret

AU - Xu, Guoquan

AU - Weiner, Lauren

AU - Gou, Yun

AU - Tommet, Douglas

AU - Brown, Charles H.

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AU - Gleason, Anne

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N2 - Purpose: Our purpose was to create a content domain framework for delirium severity to inform item development for a new instrument to measure delirium severity. Methods: We used an established, multi-stage instrument development process during which expert panelists discussed best approaches to measure delirium severity and identified related content domains. We conducted this work as part of the Better ASsessment of ILlness (BASIL) study, a prospective, observational study aimed at developing and testing measures of delirium severity. Our interdisciplinary expert panel consisted of twelve national delirium experts and four expert members of the core research group. Over a one-month period, experts participated in two rounds of review. Results: Experts recommended that the construct of delirium severity should reflect both the phenomena and the impact of delirium to create an accurate, patient-centered instrument useful to interdisciplinary clinicians and family caregivers. Final content domains were Cognitive, Level of consciousness, Inattention, Psychiatric-Behavioral, Emotional dysregulation, Psychomotor features, and Functional. Themes debated by experts included reconciling clinical geriatrics and psychiatric content, mapping symptoms to one specific domain, and accurate capture of unclear clinical presentations. Conclusions: We believe this work represents the first application of instrument development science to delirium. The identified content domains are inclusive of various, wide-ranging domains of delirium severity and are reflective of a consistent framework that relates delirium severity to potential clinical outcomes. Our content domain framework provides a foundation for development of delirium severity instruments that can help improve care and quality of life for patients with delirium.

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KW - Instrument development

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