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Validation of a French Version of the Confusion Assessment Method (CAM)

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ClinicalTrials.gov Identifier: NCT01775982
Recruitment Status : Completed
First Posted : January 25, 2013
Last Update Posted : February 1, 2017
Sponsor:
Information provided by (Responsible Party):
Centre Hospitalier Universitaire de Nīmes

Brief Summary:

To validate the French version of the CAM, a multicenter diagnostic study will be conducted. The principle of this study is identical to the study of Inouye which initially validated the CAM in 1990. This is to verify the diagnostic properties of the CAM (French version) compared to the gold standard represented by the confused state of psychiatric diagnosis using the DSM.

A representative sample of geriatric patients for whom a delirium is suspected, will be recruited in the various participating centers, patients will undergo two consecutive visits:

  • A visit by a geriatrician, during which the confused state of the patient will be evaluated using the French version of the CAM.
  • A visit by a psychiatrist during which the diagnosis of confusional state will be evaluated using the gold standard criteria of the DSM IV.

These two evaluations will be conducted on the same day and blinded from each other.

The order of these two procedures will be balanced within each center. This process will allow the calculation of diagnostic parameters of the CAM French version (validation competitive): sensitivity, specificity, positive and negative predictive values .


Condition or disease Intervention/treatment
Confusion Delirium Other: Psychiatric evaluation Other: Geriatric evaluation

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Study Type : Observational
Actual Enrollment : 102 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Validation of a French Version of the Confusion Assessment Method (CAM): a Diagnostic Tool for Acute Confusion Among the Elderly
Study Start Date : April 2014
Actual Primary Completion Date : February 2, 2016
Actual Study Completion Date : February 2, 2016

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
Study population

See inclusion and exclusion criteria.

Intervention: Psychiatric evaluation Intervention: Geriatric evaluation

A potential intervention order effect will be taken into account by balancing in each center the number of evaluations beginning with the geriatric assessment and those starting with the psychiatric assessment.

Other: Psychiatric evaluation

This evaluation is carried out in several stages:

  • Assessment of cognitive functioning;
  • Interview with a relative;
  • Interview with caregivers;
  • Evaluation of the presence of delirium according to DSM-IV criteria;
  • Evaluation of the presence of anxiety, depressive syndrome, dementia or other DSM IV;
  • Reports of adverse events.

A potential intervention order effect will be taken into account by balancing in each center the number of evaluations beginning with the geriatric assessment and those starting with the psychiatric assessment.


Other: Geriatric evaluation

This evaluation includes a brief interview with a caregiver, diverse scorings (CAM, Delirium Index, Mini Geriatric Depression Scale, Modified Early Warning Score, Clinical Global Impression sclae, Algo Plus), and adverse event reporting.

CAM scoring is carried out by a trained geriatrician and a trained nurse and/or a psychologist.

A potential intervention order effect will be taken into account by balancing in each center the number of evaluations beginning with the geriatric assessment and those starting with the psychiatric assessment.





Primary Outcome Measures :
  1. CAM French Version: diagnostic properties [ Time Frame: Day 0 ]
    Sensitivity, specificity, positive predictive value, negative predictive value


Secondary Outcome Measures :
  1. Reliability and quality of the french version of the CAM [ Time Frame: Day 0 ]

    Parameters of reliability and quality of the tool:

    • Inter-rater Agreement (measured by a coefficient of correlation) between two evaluators: geriatrician and a nurse or psychologist
    • Internal consistency of the questionnaire assessed by calculating Cronbach's alpha
    • Time required for assessment
    • Acceptability by clinicians
    • Tolerance of patients

  2. Feasibility of scoring with the French version of the Delirium Index [ Time Frame: day 0 ]
  3. Diagnostic properties of alternative algorithms constructed from items of CAM (French version) [ Time Frame: day 0 ]

Other Outcome Measures:
  1. Patient age (years) [ Time Frame: Baseline (day 0) ]
  2. Patient weight (kg) [ Time Frame: Baseline (Day 0) ]
  3. Height (cm) [ Time Frame: Baseline (day 0) ]
  4. Education level [ Time Frame: baseline (day 0) ]
    primary, secondary, or higher

  5. Living situation (qualitative) [ Time Frame: baseline (day 0) ]
    Does the patient live at home? or is the patient institutionalized?

  6. Presence/absence of a caregiver [ Time Frame: baseline (day 0) ]
  7. Hospitalization within the past 3 months? yes/no [ Time Frame: baseline (day 0) ]
  8. Has the patient fallen within the past year? yes/no [ Time Frame: baseline (day 0) ]
  9. presence/absence of a visual or hearing impairment [ Time Frame: baseline (day 0) ]
  10. patient position during evaluation [ Time Frame: baseline (day 0) ]
    qualitative variable: in bed, in a wheelchair, sitting down

  11. ADL (Activities of Daily Living) score for the 15 days preceding inclusion [ Time Frame: baseline (day 0) ]
  12. IADL (Instrumental Activities of Daily Living) score for the 15 days preceding inclusion [ Time Frame: baseline (day 0) ]
  13. ADL (Activities of Daily Living) score at the moment of inclusion [ Time Frame: baseline (day 0) ]
  14. Clinical and para-clinical examination [ Time Frame: baseline (day 0) ]
  15. Evaluation of the patient's physiological state [ Time Frame: baseline (day 0) ]
  16. Diagnosis [ Time Frame: baseline (day 0) ]
  17. Prescribed drugs [ Time Frame: baseline (day 0) ]
  18. Comorbidities (Charlson score) [ Time Frame: baseline (day 0) ]
  19. History of dementia, depression or another psychiatric disorder [ Time Frame: baseline (day 0) ]
    Notification in the patient's history of dementia, depression or another psychiatric disorder, assessed by NPI-R and Mini GDS.

  20. Severity of clinical condition [ Time Frame: baseline (day 0) ]
    Severity of clinical condition: MEWS (Subbe CP et al, 2001) and CGI (Guy W 1976) + Charlson scale

  21. Presence or absence of dementia before admission [ Time Frame: baseline (day 0) ]
    Presence or absence of dementia before admission (IQCODE French version) (Jorm AF 1994 and Law S, 1995)



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Ages Eligible for Study:   75 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients 75 years or older for whom a state of confusion is suspected during hospitalization or during a consultation for a geriatric or memory assessment.
Criteria

Inclusion Criteria:

  • A family member of the patient, or his/her "trusted person" must have given his/her informed and signed consent
  • The patient must be insured or beneficiary of a health insurance plan
  • Hospitalization in geriatric short stay OR patient consulting at a geriatric assessment center / memory clinic OR geriatric day hospitalization
  • Patients for whom a state of confusion is suspected during the pre-inclusion visit run-in based on the following criteria:
  • Presence of a cognitive function disorder as defined by a score greater than or equal to 3 on the Short Portable Mental Status Questionnaire (SPMSQ) (Pfeiffer E, 1975) AND / OR
  • Presence of a mood disorder and / or behavior disorder (regardless of duration) according to the patient's family or caregivers
  • Presence of a caregiver who can answer questionnaires concerning activities of everyday life

Exclusion Criteria:

  • The patient is participating in another study
  • The patient is in an exclusion period determined by a previous study
  • The patient's family or "trusted-person" refuses to sign the consent
  • The patient does not understand french
  • Severe aphasia
  • Stay is < = 3 days

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01775982


Locations
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France
CH d'Alès
Alès, France, 30103
CHU de Rouen - Hôpital de Bois-Guillaume
Bois Guillaume, France, 76230
APHP - Hôpital Charles Foix
Ivry Sur Seine Cedex, France, 94205
APHM - Hôpital Sainte-Marguerite
Marseille, France, 13274
CHU de Montpellier - Centre Antonin Balmes
Montpellier cedex 5, France, 34295
CHU de Nice - Hôpital de Cimiez
Nice, France, 06003
CHU de Nîmes - Hôpital Universitaire Carémeau
Nîmes Cedex 09, France, 30029
CHU de Reims - Hôpital Maison Blanche
Reims, France, 51092
Sponsors and Collaborators
Centre Hospitalier Universitaire de Nīmes
Investigators
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Principal Investigator: Valéry Antoine, MD Centre Hospitalier Universitaire de Nîmes

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Responsible Party: Centre Hospitalier Universitaire de Nīmes
ClinicalTrials.gov Identifier: NCT01775982     History of Changes
Other Study ID Numbers: PHRC-N/2011/VA-04
2011-A01161-40 ( Other Identifier: RCB number )
First Posted: January 25, 2013    Key Record Dates
Last Update Posted: February 1, 2017
Last Verified: January 2017

Keywords provided by Centre Hospitalier Universitaire de Nīmes:
French language validation
The Confusion Assessment Method (CAM)

Additional relevant MeSH terms:
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Delirium
Confusion
Consciousness Disorders
Neurobehavioral Manifestations
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Neurocognitive Disorders
Mental Disorders