Altered Mental Status: An Exploration of Definitions and Descriptors in the Literature
Bibliographic record
Abstract
Objectives: To examine the use of “altered mental status” in studies addressing states of shock, by reviewing published English literature. We explored how the term is defined and described in the literature, and alternative words/phrases used. Background: Assessment of mental status is crucial for patients in shock and life-threatening conditions. The term “altered mental status” is being used inconsistently, and varied means of assessment have been reported, which may have implications for critical care nurses' training and implementation of clinical practice guidelines. Methods: A systemized literature review based on targeted searches in CINAHL and MEDLINE, with predefined eligibility criteria. Primary studies, reviews and case studies were included. Results: Based on eligibility criteria, 92 articles were included (48 primary studies, 32 case reports, 12 review articles). Glasgow Coma Scale (GCS) was most frequently used to define “altered mental status” followed by the terms “unconsciousness”, “confusion” “coma” and “disorientation”. Changes in consciousness were described in a variety of expressions, i.e. decreased level of consciousness, change in awareness, and GCS. Conclusion: There is no universal definition for altered mental status. More work is needed towards an accurate definition standardization of use of related terms, and consensus on the most valid assessment methods in order to identify patients with high risk for deterioration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.068 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.065 | 0.055 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.007 | 0.012 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".