Understanding the biological and clinical correlates of delirium: Development of Reporting Essentials for Delirium bioMarker Studies (REDEEMS)
- Publication Type:
- Thesis
- Issue Date:
- 2021
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๐๐ฎ๐ฐ๐ธ๐ด๐ฟ๐ผ๐๐ป๐ฑ
Delirium is a common, serious and complex neurocognitive condition that is associated with negative impacts for both the person with delirium and their family/carers. Despite the significant burden, the pathophysiology of delirium remains unclear. To improve this understanding, robust delirium biomarker studies with optimal reporting are urgently needed to ensure each of these studies contribute to accelerate our knowledge.
๐๐ถ๐บ
To evaluate and optimize the methodological approaches in research evaluating biological and clinical correlates of delirium and underlying conditions.
๐๐ฒ๐๐ถ๐ด๐ป
A multiple methods project, involving three discreet but inter-related studies conducted over three stages.
๐ ๐ฒ๐๐ต๐ผ๐ฑ๐
Study 1 was a systematic review of the overlap of delirium and advanced cancer-related syndrome biomarkers as an โexamplarโ of the potential for interaction between the underlying condition and delirium; Study 2a was a three-stage modified Delphi study with delirium researchers and study 2b was a consensus meeting to generate a reporting guideline specific to delirium biomarker studies (REDEEMS). Study 3 comprised a series of semi-structured interviews on the key challenges of conducting delirium biomarker studies.
๐ฅ๐ฒ๐๐๐น๐๐
The systematic review identified considerable overlap of delirium and advanced cancer biomarkers, with 41 biomarkers that had been studied in relation to both delirium and an advanced cancer-related syndrome. It also revealed a significant gap in the consistency and reporting of delirium biomarker studies. Considering this unexpected finding, a drive to improve the methods of reporting delirium biomarker studies was warranted. The Delphi study and consensus meeting revealed a total of nine items which were deemed critical elements by delirium researchers for inclusion in the REDEEMS guideline. Finally, the qualitative study identified a range of factors that contribute to the challenges and overall quality of delirium biomarker research. Analysis revealed two major themes: 1) Practical and scientific challenges of delirium biomarker research: stagnation versus driving improved methods and reporting; and 2) Valuing delirium research through investment and collaboration.
๐๐ผ๐ป๐ฐ๐น๐๐๐ถ๐ผ๐ป
The REDEEMS guideline is the first reporting guideline specific for delirium biomarker studies. It aims to guide improvements in consistency and transparency of reporting future biomarker studies in delirium, conceivably permitting accurate replication and synthesis, and improving scientific rigor in the field. A collaborative effort to increase awareness of, and improve research funding for delirium is needed, along with increased education and training in delirium biomarker methodology. These advancements will lead to significant improvement of our understanding of delirium pathophysiology and ultimately improve outcomes for people with delirium.
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