Reporting individual symptoms in postoperative delirium studies: Protocol for a systematic review
Notice bibliographique
Résumé
Objectives Delirium is a nonspecific cerebral syndrome characterised by an acute and transient alteration in cognition and attention. This may affect memory, orientation, language and perception, which cannot be accounted for by pre-existing dementia. Delirium studies often report delirium as a dichotomous outcome, providing limited information into the potential phenotypes of delirium which are present within the population, and the symptom profiles patients are experiencing. Delirium is particularly common in patients who have undergone surgery. In this systematic review, we aim to identify studies of these populations which report and record symptoms of delirium individually, as well as whether they record delirium psychomotor subtype and severity. Methods This systematic review has been registered with Prospero: CRD42021236622 This systematic review will be conducted in accordance with PRISMA 2020 guidelines. We will search Medline, Embase and Web of Science for studies of any language and any publication date. An example of the search strategy is shown in Table 1. These studies will include only patients over the age of 18, and patients undergoing surgery of any type in hospital, who develop postoperative delirium, and report its individual symptoms. Only studies that report individual symptoms of delirium will be included. We will include all clinical trials, randomised controlled trials, observational studies, and qualitative studies including interventional design studies. Case reports, cases series, editorials, reviews, systematic reviews and animal studies will be excluded. Studies which include patients with pre-existing diagnosed dementia, pre-operative delirium, Wernicke’s encephalopathy, brain tumours, brain aneurysms, neurological disorders or studies involving alcohol abuse and withdrawal will also be excluded. Two independent, blinded, reviewers will assess abstracts and titles for eligibility. Results Due to the nature of our research question, we anticipate a high number of studies to be included for full-text review. This stage will involve 8 fully-trained independent reviewers; each paper will be screened in duplicate, and quality-control methods conducted. Data will be extracted and quality appraised using the Newcastle Ottawa Scale, by two independent reviewers. Missing data will be addressed by contacting study authors in the first instance, but alternatively by noting the limitation or excluding the study, depending on the extent of the missing data. Our findings of how many studies report on individual delirium symptoms will be reported by a narrative synthesis. Discussion/Conclusion Current methods of reporting delirium by dichotomous outcome or psychomotor subtype provide little information on the full clinical and biological profile of the patient. This is limiting knowledge of the potential delirium phenotypes. By reporting, discussing and comparing the differences in symptoms reported in delirium studies, we can highlight the importance of individuality in reports, alongside the spectrum of delirium presentations that occur. This would emphasise the importance of identifying subphenotypes of delirium, expanding knowledge of the condition and therefore progressing research into targeted treatments. This review should encourage the study of symptom profiles occurring in various populations, alongside predisposing and precipitating delirium risk factors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,074 | 0,114 |
| Méta-épidémiologie (sens strict) | 0,006 | 0,006 |
| Méta-épidémiologie (sens large) | 0,023 | 0,022 |
| Bibliométrie | 0,015 | 0,016 |
| Études des sciences et des technologies | 0,004 | 0,005 |
| Communication savante | 0,008 | 0,011 |
| Science ouverte | 0,005 | 0,007 |
| Intégrité de la recherche | 0,006 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,083 | 0,009 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».