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A Meta-analysis of Diagnostic Accuracy of the CAPD for Detecting Pediatric
Intensive Care Unit Delirium

1
I. Rohmah and H. Chiu 1

Taipei Medical University, Chinese Taipei
1

Background: Delirium is a complication related to critical illness, affecting 34% of children admitted
to pediatric intensive care units (PICUs). The Cornell Assessment of Pediatric Delirium (CAPD) is the
commonly used assessment tool for detecting pediatric intensive care unit (ICU) delirium. To date, no
study has examined the diagnostic accuracy of the CAPD for screening PICU delirium. Furthermore,
the moderating effects of study features and patient characteristics on diagnostic accuracy of the
tool remained unanswered.

Objective: We aimed to summarize the diagnostic accuracy of the tool in the detection of delirium in
pediatric intensive care units.

Methods: We conducted a systematic review and meta-analysis. PubMed, Embase, CINAHL, and
Oral Presentation Abstracts
ProQuest Dissertations and Theses A&I were used to conduct a thorough search from the database’s
inception to March 1, 2023. The study examined the sensitivity and specificity of CAPD in relation to gold
standards such as the DSM and clinical observation for delirium screening in PICUs. Two researchers
independently identified articles, extracted data, and assessed the risk of bias for each study by
using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A bivariate diagnostic
statistical analysis with a random-effects model was performed. The funnel plot proposed by Deeks
was employed to assess the presence of publication bias.

Results: Seven studies for the CAPD were identified. All studies had a low risk of bias in applicability.
The pooled sensitivity was 0.95 (95% CI:0.85-0.99) while pooled specificity was 0.81 (95% CI:0.68-0.90).
Significant between-study heterogeneity was observed in the pooled sensitivity and specificity
(Q = 20.44 and 55.46, both p < 0.001; I2 = 70.64% and 89.18%, respectively). We did not identify any
variable explaining heterogeneity for the CAPD. Deeks’ funnel plot revealed no evidence of significant
publication bias (p > 0.01).

Conclusion: The CAPD is an accurate assessment tool for screening delirium in critically ill pediatric
patients.

Keywords: critical care, delirium, pediatric intensive care delirium screening checklist

_____________________________________________________________________________________________________
Correspondence: Hsiao-Yean Chiu, Taipei Medical University, Chinese Taipei
E-mail: hychiu0315@tmu.edu.tw

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