Objective: To evaluate the sensitivity, specificity and test-retest reliability of the Delirium Early Monitoring System- Delirium Observation Screening Scale (DEMS-DOSS). Design: Cross-sectional study of admitted older adults with DEMS-DOSS and reference standard assessments. Setting: 60-bed aged care precinct at a metropolitan hospital in Sydney, Australia. Participants: 156 patients (aged ≥65 years old) were recruited to participate between April 2018 and March 2020. Measurements: Participants were scored on the DEMS-DOSS. Trained Senior Aged Care Nurses conducted a standardised clinical interview based on the DSM-IV delirium criteria, within two-hours of DEMS-DOSS completion. The Senior Aged Care Nurse undertaking the DSM-IV interview was blinded to the results of the DEMS-DOSS.
Results: Participants mean age was 84 (±7.3) years and 38.2% (n=39) had a documented diagnosis of dementia. Delirium was detected in 37.3% (n=38). The DEMS-DOSS had a sensitivity of 75.8% and a specificity of 75.8% for delirium. The area under the receiver operating characteristics curve for delirium was 0.76. The test-retest reliability of the DEMS-DOSS was found to be high (r=0.915). Conclusion: DEMS-DOSS is a sensitive and specific tool to assist with monitoring delirium in hospitalised older adults. Further studies are required to evaluate the impact of the DEMS-DOSS on health outcomes.