CAM (Confusion Assessment Method) : Critères diagnostics de Confusion mentale
Auteur : Dr. Carmelo Lafuente
Dernière mise à jour : 04/05/2024
Ensemble de critères développé dans les années 1990 comme outil pour le dépistage et diagnostic de la confusion mentale aigue (delirium en anglais). Il a été postérieurement adapté aux nouveaux critères DSM de confusion mentale.
La CAM s'est révélé l'un des outils les plus performants dans le repérage et diagnostic de la confusion mentale, tout en étant un peu plus facile à appliquer en clinique que les critères DSM-V.
Utilité :
Dépistage et diagnostic positif d'une confusion mentale.
Echèlle :
Les 2 premières critères + l'un des critères 3 ou 4 sont requis.
Critères
Interprétation
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Critères 1 et 2 + l'un des critères 3 ou 4
Diagnostic de confusion mentale (sd. confusionnel, ou confusion aigue)
Indications
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Critères cliniques de référence pour le diagnostic de confusion mentale. Plus simples et faciles à appliquer que les critères DSM-V
Scores, Listes similaires
Références
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Lin 2023. Revue systématique : Delirium assessment tools among hospitalized older adults: A systematic review and metaanalysis of diagnostic accuracy. Ageing Res RevA total of 38 studies involving 7378 patients were included. The 4AT, Nu-DESC, and CAM had comparable sensitivity in detecting delirium (0.76, 0.78, and 0.80, respectively). However, the specificity of the CAM was higher than that of the 4AT (0.98 vs 0.89, P = .01) and Nu-DESC 0.99 vs 0.90, P = .003). Diagnostic accuracy was moderated by the percentage of women, acute care setting, sample size, and assessors. The three tools exhibit comparable sensitivity, and the CAM has the highest specificity
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van Velthuijsen 2016. Revue systématique : Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: a systematic review. Int J Geriatr Psychiatry.. Quality assessment resulted in 37 studies with a positive quality assessment, describing 23 instruments. .. The Delirium Observation Screening Scale (DOS) and Nu-DESC are observational instruments with good psychometric properties, but the Nu-DESC is shorter .. The CAM is the most widely studied and demonstrates the best psychometric properties
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Wong 2010. Revue systématique : Does this patient have delirium?: value of bedside instruments. JAMA.. identified with 25 prospectively conducted studies (N = 3027 patients) meeting inclusion criteria and describing use of 11 instruments. .. Considering the instrument's ease of use, test performance, and clinical importance of the heterogeneity in the confidence intervals (CIs) of the LRs, the CAM has the best available supportive data as a bedside delirium instrument (summary-positive LR, 9.6; .. summary-negative LR, 0.16 ..). Of all scales, the MMSE (score <24) was the least useful