91AV

91AV College of Osteopathic Medicine (91AV COM) student Brett Armstrong (D.O., ’22) is a lead author of a new article that examines the effectiveness of a mobile application to screen for delirium among hospitalized patients.

According to the article, published in May in the Journal of the American Medical Informatics Association (JAMIA), up to one-third of hospitalized older adults experience delirium, yet over half of cases go unrecognized. 

Patients who develop delirium have an increased risk of death, institutionalization, and cognitive decline, the researchers wrote. Delirium also has significant financial impacts: the estimated annual costs of delirium in the United States are $164 billion. For these and other reasons, the authors argued, it is critical to have efficient and accurate methods for screening and identifying the disorienting condition. 

The research team developed an iPad app that facilitated administration of an adaptive two-step protocol for delirium diagnosis and assessed its usability among three types of clinicians — doctors, nurses, and certified nurse assistants (CNAs) — among older patients at two hospitals. The app was used as part of a National Institutes of Health-funded project to assess the feasibility, effectiveness, administration time, and costs of using the two-step protocol and was found to be successful during the study.

Clinicians performed 881 delirium assessments using the app for 535 patients. The transmission of data between the app and the selected relational database system, Research Electronic Data Capture (REDCap), showed no errors. Qualitative data indicated that the users were enthusiastic about using the app, with 82% of users giving positive comments, 18% making suggestions for improvement, and none leaving negative feedback.

“Through many other projects on delirium, we understand how important it is to effectively screen for and detect the condition, as it has numerous adverse effects on our patients,” Armstrong said of the study. “Identifying delirium is important to providing effective patient care, and we believe that this app has the potential to allow health care providers in a diverse array of settings to more efficiently and accurately assess patients for this condition and provide prompt treatment.”

The researchers also point out that their app, developed on Apple’s iOS operating system, can be easily adapted to other operating systems such as Android, Microsoft Windows, or Linux, which would expand accessibility to additional health care providers. 

Armstrong said he is grateful for the opportunity to pursue research during his time as a student at 91AV.

“I am fortunate that I was able to continue contributing to this study and the manuscript once I began medical school at 91AV,” Armstrong remarked. “I began working with this team nearly two years before medical school and am grateful for the opportunity and experiences.”