title: Evaluation of the memorial delirium assessment scale (MDAS) for the screening of delirium by means of simulated cases by palliative care health professionals.
abstract: BACKGROUND
  Delirium is among the most common neuropsychiatric complications of advanced cancer. The Memorial Delirium Assessment Scale (MDAS) is a widely used and validated screening tool for delirium in cancer patients.
  
  
  OBJECTIVE
  The purpose of this study was to assess the use of the MDAS by different palliative care health professionals after receiving formal training and a guiding manual for administration and scoring.
  
  
  METHODS
  Thirty-one palliative care health professionals received a training session on the MDAS, including description of the tool, validation, and scoring. Participants also received copies of a proposed standardized manual for completion of the MDAS. Two of the investigators presented three simulated cases to the participants, who independently completed a scoring sheet for each case. The data were then analyzed according to the cases and the profession of the operators.
  
  
  RESULTS
  Thirty-one scoring sheets were analyzed (11 physicians, 12 nurses, and 8 others). A correct diagnosis was achieved by 30 (96.8%) of the 31 participants in case 1 (nondelirious, true score = 5, median = 5, range = 2-15), 28 of 31 (90.3%) in case 2 (severe mixed delirium, true score = 20, median = 18, range = 10-26), and 31 of 31 in case 3 (mild hypoactive delirium, true score = 14, median = 19, range = 13-25). Overall percentage of error was 31% for items 2, 3, and 4 (cognitive) and 45% for all other items (observational) (p < 0.001). The percentage of error did not differ between physicians and nurses and other palliative care professionals (p > 0.99).
  
  
  CONCLUSIONS
  Our preliminary results suggest that adequate training and a guiding manual can enhance the application of MDAS by palliative care health professionals in the teaching settings. Clinical studies to assess the utility of the MDAS as a screening tool are justified to further confirm these findings.
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
authors: Nada
authors: N
authors: Fadul
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
authors: Guddi
authors: G
authors: Kaur
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
authors: Tao
authors: T
authors: Zhang
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
authors: J Lynn
authors: JL
authors: Palmer
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA. ebruera@mdanderson.org.
authors: Eduardo
authors: E
authors: Bruera
mesh_terms: D003693:Delirium / Q000175:diagnosis*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007318:Inservice Training / Q000379:methods; D008403:Mass Screening / Q000295:instrumentation*; D010166:Palliative Care; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014481:United States