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Table 3 Reliability between two raters for delirium classification systems and their individual criteria

From: Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study

Classification Systems and their Criteria Reliability whole sample (n = 200) Reliability dementia subset (n = 117)
Kappa 95 % CI Kappa 95 % CI
DSM-III-R 0.62 0.49–0.75 0.58 0.42–074
A Alteration to maintain and shift attention 0.61 [0.58] 0.50–0.73 0.48 [0.52] 0.32–0.54
B Disorganized thinking 0.42 [0.67] 0.29–0.55 0.35 [0.61] 0.18–0.52
C Alterations in two of: consciousness, perception, sleep – wake cycle, motor activity, orientation and memory. 0.66 [0.61] 0.55–0.77 0.29 [0.57] −0.02–0.60
D Acute onset and fluctuation tendency. 0.58 [0.62] 0.46–0.70 0.51 [0.58] 0.35–0.67
E Evidenced or presumed etiological cause. 0.45 [0.62] 0.33–0.57 0.35 [0.58] 0.18–0.51
DSM-IV 0.63 0.50–0.76 0.54 0.37–0.72
A Disturbance of consciousness and attention 0.59 [0.56] 0.47–0.71 0.45 [0.47] 0.29–0.61
B Cognition alteration or perceptual disturbance, not explained by a dementia. 0.43 [0.66] 0.31–0.56 0.31 [0.59] 0.15–0.48
C Acute onset and fluctuation tendency. 0.61 [0.63] 0.49–0.73 0.54 [0.53] 0.39–0.70
D Evidence for etiology. 0.57 [0.64] 0.46–0.68 0.47 [0.56] 0.31–0.62
DSM-5 0.73 0.62–0.84 0.67 0.53–0.82
A Disturbance in attention and awareness. 0.67 [0.73] 0.56–0.78 0.57 [0.67] 0.42–0.71
B Acute onset and fluctuation tendency. 0.71 [0.71] 0.60–0.81 0.63 [0.65] 0.48–0.77
C Additional cognitive change or perception disturbance. 0.47 [0.73] 0.33–0.62 0.30 [0.67] –0.5–0.64
D No better explanation by another neurocognitive disorder nor reduced level of arousal. 0.68 [0.70] 0.57–0.79 0.61 [0.62] 0.49–0.76
E Evidence for etiology. 0.58 [0.72] 0.47–0.69 0.46 [0.65] 0.31–0.61
ICD-10 0.57 0.42–0.73 0.49 0.29–0.68
A Clouding of consciousness and attention alteration. 0.58 [0.59] 0.45–0.70 0.45 [0.52] 0.29–0.61
B Disturbance of cognition (memory and orientation). 0.69 [0.59] 0.59–0.79 0.52 [0.54] 0.32–0.72
C One psychomotor disturbance (shifts from hypo to hyperactivity, reaction time increased, speech increased /decreased, enhanced startle reaction) 0.52 [0.55] 0.40–0.64 0.49 [0.45] 0.32–0.65
D One alteration of sleep – wake (insomnia, nocturnal worsening, nightmares) 0.52 [0.56] 0.40–0.64 0.49 [0.52] 0.33–0.65
E Rapid onset and fluctuations. 0.58 [0.54] 0.45–0.71 0.50 [0.49] 0.34–0.66
F Evidence for an etiologic cause. 0.50 [0.57] 0.39–0.62 0.37 [0.47] 0.21–0.53
  1. Kappa for each classification system if each individual criterion were excluded is within brackets. Values in the questionable or unacceptable ranges are italicized. Values in the good range are bolded. K: <0.20 = unacceptable, 0.20–0.39 = questionable, 0.40–0.59 = acceptable, 0.60–0.79 = good, and 0.80–1 = excellent