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Confusion

2015· book-chapter· en· W4250954394 on OpenAlexaboutno aff
Hugo Farne, Edward Norris-Cervetto, James Warbrick‐Smith

Bibliographic record

VenueOxford University Press eBooks · 2015
Typebook-chapter
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsnot available
Fundersnot available
KeywordsDeliriumPsychologyDementiaConfusionCognitionCognitive impairmentConsciousnessMinimally conscious statePsychiatryCognitive psychologyMedicineNeuroscience

Abstract

fetched live from OpenAlex

• Delirium: an acute impairment in cognitive ability together with impaired consciousness. • Dementia: a chronic, progressive impairment in cognitive ability but with intact consciousness. Note that this is different from delirium and that you cannot diagnose dementia from a single mental status assessment. • Mental impairment: a permanent impairment in cognitive ability. • Psychosis: the patient may not be confused, but have a disorder of thought content/perception (e.g. delusions and/or hallucinations). • Receptive dysphasia: the patient may have difficulties comprehending your questions (e.g. due to damage to Wernicke’s area of the brain). • Expressive dysphasia: the patient may be cognitively intact but have difficulties verbalizing an answer to your questions (e.g. due to damage to Broca’s area of the brain). Note that these syndromes may coexist in patients, particularly delirium and dementia which are both very common. Remember to start by checking the patient’s airway, breathing, and circulation (ABC) and whether they are in any pain that requires analgesia. To work out what type of confusion this is, you should start by conducting a quick screen of confusion because if the patient does poorly in your screen, taking a conventional history may prove unhelpful. For example, you may ask: • Are they oriented to time, place, and person? Can they tell you why they are here? The Abbreviated Mental Test Score (AMTS; see Box 2.1) is a simple 10-question screening tool for assessing confusion where a score of less than 6/10 indicates cognitive impairment. An alternative is the 30-question Mini Mental State Exam (MMSE), where a score of less than 26/30 indicates cognitive impairment. Be aware that there are many other scoring systems in routine use, such as the Confusion Assessment Method (CAM), Montreal Cognitive Assessment (MoCA), etc. • If their ability to converse is impaired, can they follow a three-step command? Can they name three common objects? These questions test for receptive and expressive dysphasia respectively. It will be fairly obvious early in your interaction with the patient whether either of these questions is relevant (they do not need to be asked routinely). • Other symptoms? Are they in pain? (even the most confused patient will complain of pain). You should also ask about breathlessness, cough, and urinary symptoms as a chest or urinary tract infection (UTI) is often the cause of confusion.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.011
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: none
GenreCandidate signal: Other · Consensus signal: Other
Teacher disagreement score0.244
Threshold uncertainty score0.000

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.011
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.001
Science and technology studies0.0030.001
Scholarly communication0.0040.003
Open science0.0020.005
Research integrity0.0020.003
Insufficient payload (model declined to judge)0.2440.160

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.

Opus teacher head0.064
GPT teacher head0.281
Teacher spread0.217 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designTheoretical or conceptual
Domainnot available
GenreOther

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".

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Citations0
Published2015
Admission routes1
Has abstractyes

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