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Australian researchers develop a world-first app to test for delirium

Photo: Australian researchers develop a world-first app to test for delirium
A team of Australian researchers has developed a world-first app that will test for delirium in patients being admitted into Intensive Care Units (ICUs). The iPad app will help doctors diagnose delirium faster and more accurately, significantly improving patient safety, comfort and health outcomes.

Delirium affects cognitive functioning, creating an acute state of confusion as the central nervous system becomes dysfunctional. The condition is reversible but until properly diagnosed, it can put vulnerable patients at event greater risk as they struggle to reliably express their pain and distress to medical professionals.

Delirium is considered the single most common acute disorder affecting adults in general hospitals. Every year 130,000 Australians will be admitted into ICUs around the country, with an estimated 80% believed to be suffering delirium, but up until now there hasn’t been an accurate test for the condition. If Australian patients stay one extra day in an ICU due to a delay in diagnosis, it costs the Australian health-care system between $90-$200 million per year.
In the United States delirium is also believed to affect upwards of 80% of patients accounting for over 7 million Americans annually. This is estimated to cost more than $143 billion annually, mostly in longer hospital stays  – up to 12 days longer than patients who don’t develop the condition – and follow-up care in nursing homes.

Delirium can occur at any age but it disproportionately affects people older than 65, and as a result is often misdiagnosed as dementia. It’s also common among patients recovering from surgery and could even be triggered by something as simple as a urinary tract infection. Regardless of the cause, delirium can persist for months after discharge, with long-term effects on cognitive function.

“Until now, there hasn’t been a test for delirium so it was difficult to measure who has it, who doesn’t and whether or not it was getting worse without being able to establish the person’s usual level of mental function,” says Professor John Fraser, Director of Critical Care Research Group at The Prince Charles Hospital and team leader on the Delirium App.

“Patients with delirium often provide doctors with very little or misleading information which results in delays in diagnosis. With our hospital systems already stretched to capacity it’s critical that the patient’s underlying issue is treated effectively and without delay, and that the ICU is working at optimal efficiency.”

The Prince Charles Hospital Foundation’s innovative medical funding movement The Common Good provided funding for the ground-breaking Delirium App. The predominantly visual screening tool has been designed to be as language-free and culture-neutral as possible to ensure the widest possible implementation. The app seeks to measure a patient’s level of cognitive function and higher-level thinking processes with a series of visual cues that test working memory, temporal sequencing and executive function.

“The Delirium App is currently being used in the Prince Charles Hospital ICU, and with a recent validation test registering 94% accuracy in the diagnosis of delirium, we are aiming to roll it out across ICUs nationally. Once the app is being broadly used it will not only improve the speed and accuracy of delirium diagnosis, but we will be able to accurately determine the extent of the problem.

“The Delirium App has the potential to significantly improve the function and operation of ICUs not just around the country, but around the world,” added Professor Fraser.

Michael Hornby, CEO of The Prince Charles Hospital Foundation, adds, “It is incredible to think that something so simple as an iPad app has the potential to help doctors and nurses effectively diagnose delirium in ICUs. The Delirium App was developed with initial funding of just $10,000 but we now need to raise an additional $200,000 to take it to the next stage of development in preparation of making it available in hospital settings around Australia and globally.  To do this we are asking the community to support our work through The Common Good.

“This is a tool that will not only assist doctors and nurses in ICUs to diagnose delirium, it will deliver significant savings to the health-care system and improve patient outcomes, which benefits all Australians. We hope you can join us in funding this simple idea that has the potential to change the direction of critical patient care in Australian ICUs.”

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