Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro)

Abstract

Objective: The Delirium Diagnostic Tool-Provisional (DDT-Pro) was designed to detect the presence and severity of delirium briefly and objectively regardless of psychiatric expertise. We translated the DDT-Pro into Korean and validated it in elderly Korean patients.

Methods: To validate the translation and evaluate inter-rater reliability, a psychiatric trainee and a research nurse independently assessed the same patients referred to the Department of Psychiatry. The results were compared with the reference evaluations performed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

Results: We enrolled 42 elderly patients. The Cronbach's alpha coefficient were 0.839 (the trainee), 0.822 (the nurse). The Cohen's weighted κ between the trainee and nurse, ranged from 0.555±0.102 to 0.776±0.062. The Pearson correlation coefficients (Korean version of the DDT-Pro [K-DDT-Pro] and Korean version of the Delirium Rating Scale-Revised-98 [DRS-R98-K] total score) were γ=-0.850 (the trainee), and γ=-0.821 (the nurse). The areas under the ROC curves (AUCs) were 0.974 (the trainee) and 0.893 (the nurse).

Conclusion: The K-DDT-Pro exhibited high internal consistency and relatively substantial inter-rater reliability. The correlation with the DRS-R98-K was strongly negative. The accuracy of the K-DDT-Pro was excellent, regardless of expertise. In conclusion, the K-DDT-Pro is a brief and simple tool that usefully screens for delirium in elderly patients.

Keywords: Delirium; K-DDT-Pro; Reliability; Validity.

Figure 1.

The process of the assessment. DSM-5, Diagnostic and Statistical Manual of Mental Disorders, 5th Edition; K-DDTPro, Korean version of the Delirium Diagnostic Tool-Provisional; DRS-R98-K, Korean version of the Delirium Rating Scale-Revised-98.

Figure 2.

Flow diagram of the study participants. ^*when the patient has severe hearing loss or can neither talk nor motion a response. DSM-5, Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Figure 3.

AUC for the K-DDT-Pro for delirium diagnosis (DSM-5 independent diagnosis). K-DDT-Pro, Korean version of the Delirium Diagnostic Tool-Provisional; AUC, area under the receiver operating characteristic curve; CI, confidence interval.