{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T20:40:10Z","timestamp":1750365610742,"version":"3.41.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Delirium, an acute mental status change associated with inattention, confusion, hypervigilance, or somnolence due to a medical cause, is considered a medical emergency. Unfortunately, screening and diagnosis of delirium in acute care are often inadequate. It is estimated that 60% of delirium cases are not identified, and in claims data, they are underreported. Using information technology, we investigated whether concept unique identifiers from the Unified Language Medical System Metathesaurus could be used as a method to filter electronic health records for possible delirium cases. This article provides the reader with an overview of delirium, the Unified Language Medical System Metathesaurus, and our method for retrospectively filtering electronic health records for delirium cases from our clinical research database. Using a retrospective observational approach, we randomly selected 150 electronic health records with narrative notes containing a delirium concept unique identifier. One hundred records were used for training and 50 were used for validation and interrater reliability. Our results validate electronic health record\u2013selected concept unique identifiers and provide insights into their use. Refinement and application of this method on a larger scale can provide an initial filter for identifying patients with delirium from the electronic health record.<\/jats:p>","DOI":"10.1097\/cin.0000000000000710","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T03:23:40Z","timestamp":1619493820000},"page":"471-476","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Using Concept Unique Identifiers to Filter Electronic Health Records for Delirium Cases"],"prefix":"10.1097","volume":"39","author":[{"given":"Kimberly J.","family":"Oosterhouse","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia D.","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manushi","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Birch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Price","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen L.","family":"Bobay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"bib2-20250619","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","article-title":"Delirium in elderly people","volume":"383","year":"2014","journal-title":"Lancet"},{"key":"bib3-20250619","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1007\/s00520-015-2610-3","article-title":"The frequency of missed delirium in patients referred to palliative care in comprehensive cancer center","volume":"23","year":"2015","journal-title":"Supportive Care in Cancer"},{"issue":"5","key":"bib4-20250619","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.psym.2016.06.001","article-title":"Underreporting of delirium in statewide claims data: implications for clinical care and predictive modeling","volume":"57","year":"2016","journal-title":"Psychosomatics"},{"issue":"4","key":"bib5-20250619","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1093\/ageing\/afl005","article-title":"Occurrence and outcome of delirium in medical in-patients: a systematic literature review","volume":"35","year":"2006","journal-title":"Age Ageing"},{"issue":"1","key":"bib6-20250619","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.psc.2017.10.001","article-title":"Delirium in the elderly","volume":"41","year":"2018","journal-title":"The Psychiatric Clinics of North America"},{"issue":"3","key":"bib7-20250619","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3928\/00989134-20161109-01","article-title":"Hospitalized older adults with established delirium: recognition, documentation, and reporting","volume":"43","year":"2017","journal-title":"Journal of Gerontological Nursing"},{"issue":"4","key":"bib8-20250619","doi-asserted-by":"crossref","first-page":"379","DOI":"10.4037\/aacnacc2016535","article-title":"Intensive care unit nurses' beliefs about delirium assessment and management","volume":"27","year":"2016","journal-title":"AACN Advanced Critical Care"},{"issue":"10","key":"bib9-20250619","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1007\/s00134-008-1177-6","article-title":"Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients","volume":"34","year":"2008","journal-title":"Intensive Care Medicine"},{"issue":"8","key":"bib10-20250619","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3928\/00989134-20150723-01","article-title":"The language of delirium: keywords for identifying delirium from medical records","volume":"41","year":"2015","journal-title":"Journal of Gerontological Nursing"},{"issue":"4","key":"bib11-20250619","doi-asserted-by":"crossref","first-page":"e181405","DOI":"10.1001\/jamanetworkopen.2018.1405","article-title":"Electronic prediction rules for prevalent delirium at hospital admission","volume":"1","year":"2018","journal-title":"JAMA Network Open"},{"issue":"3","key":"bib14-20250619","article-title":"Informatics: evolution of the Nelson Data, Information, Knowledge and Wisdom Model: part 1","volume":"23","year":"2018","journal-title":"Online Journal of Issues in Nursing"},{"issue":"1","key":"bib15-20250619","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4258\/hir.2019.25.1.1","article-title":"Managing unstructured big data in healthcare system","volume":"25","year":"2019","journal-title":"Healthcare Informatics Research"},{"issue":"1","key":"bib17-20250619","first-page":"20","article-title":"What are ontologies, and why do we need them?","volume":"14","year":"1993","journal-title":"IEEE Intelligent Systems"},{"key":"bib20-20250619","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/j.1532-5415.2005.53120.x","article-title":"A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method","volume":"53","year":"2005","journal-title":"Journal of the American Geriatrics Society"},{"issue":"1","key":"bib21-20250619","doi-asserted-by":"crossref","first-page":"23","DOI":"10.20982\/tqmp.08.1.p023","article-title":"Computing inter-rater reliability for observational data: an overview and tutorial","volume":"8","year":"2012","journal-title":"Tutorial in Quantitative Methods for Psychology"},{"issue":"5","key":"bib22-20250619","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/0895-4356(93)90018-V","article-title":"Bias, prevalence and kappa","volume":"46","year":"1993","journal-title":"Journal of Clinical Epidemiology"},{"issue":"1","key":"bib23-20250619","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jamda.2016.07.014","article-title":"The diagnosis of delirium superimposed on dementia: an emerging challenge","volume":"18","year":"2017","journal-title":"Journal of the American Medical Directors Association"}],"container-title":["CIN: Computers, Informatics, Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/CIN.0000000000000710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T20:01:11Z","timestamp":1750363271000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/CIN.0000000000000710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,22]]},"references-count":17,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/cin.0000000000000710","relation":{},"ISSN":["1538-9774"],"issn-type":[{"type":"electronic","value":"1538-9774"}],"subject":[],"published":{"date-parts":[[2021,4,22]]}}}