{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:27:00Z","timestamp":1784384820263,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diagnostic criteria for emergence agitation are sensitive but not specific; they misclassify patients who are angry or upset as having emergence delirium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this three\u2010phase study was to determine expert agreement on the behaviors that differentiate children with emergence delirium from those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the first phase of this observational study, pediatric dental patients were video recorded while awakening from anesthesia. In the second phase, salient 10\u2009s segments of the recordings showing patient activity were shown to an expert audience of pediatric dentists, anesthesiologists and Post Anesthetic Care nurses, who scored the recordings as showing or not showing \u201ctrue emergence delirium.\u201d In phase 3, the video segments were assessed by three research assistants using a behavior checklist for features that discriminate between those scored \u201ctrue emergence delirium\u201d and those scored \u201cNOT true emergence delirium\u201d by the experts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty\u2010four pediatric dental patients were included. Subsequently, an expert audience consisting of 10 anesthesiologists, 12 anesthesiology residents, 3 pediatric dentists, and 4 experienced Post Anesthesia Care Unit nurses rated each 10\u2010second video segment. This resulted in three groups of patients: a group for whom all experts agreed was \u201cTrue emergence delirium\u201d (<jats:italic>n<\/jats:italic>\u2009=\u200933; CI 21 to 45), a group for whom all agreed was \u201cNot True emergence delirium\u201d (<jats:italic>n<\/jats:italic>\u2009=\u2009120; CI 107 to 133), and a group where experts disagreed (<jats:italic>n<\/jats:italic>\u2009=\u200911; CI 4 to 18). Three research assistants then completed a behavior checklist for each of the 33 \u201cTrue emergence delirium\u201d video segments and matched \u201cNot True\u201d controls. Twenty\u2010four behaviors were identified as significantly different between videos scored True emergence delirium and those scored Not True emergence delirium. Research assistants reached almost perfect agreement (0.81\u20131.00) on one behavior, and substantial agreement (0.61\u20130.80) on seven behaviors that characterized \u201cTrue emergence delirium.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Eight behaviors that differentiate pediatric dental patients with emergence delirium from those without were found. These discriminators may be used to develop a scale that will lead to better diagnosis and treatment of emergence delirium.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14678","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T07:16:06Z","timestamp":1682406966000},"page":"631-635","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Identifying behaviors that characterize emergence delirium: An observational study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5826-5245","authenticated-orcid":false,"given":"Jennifer M.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Pain Management University of Saskatchewan  Saskatoon Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-5960","authenticated-orcid":false,"given":"William P. S.","family":"McKay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Pain Management University of Saskatchewan  Saskatoon Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6147-7935","authenticated-orcid":false,"given":"Marguerite","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Pain Management University of Saskatchewan  Saskatoon Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000062522.21048.61"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew477"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.1999.00415.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200405000-00015"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.00868.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.20097"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(00)00180-X"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03646.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2223\/JPED.1763"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev552"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12580"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.54.101601.145102"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.06.042"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199710000-00012"},{"key":"e_1_2_12_16_1","first-page":"651","article-title":"Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery","volume":"118","author":"Kain ZN","year":"2006","journal-title":"Paediatrician"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aco.0000188420.84763.35"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200106000-00011"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000287009.46896.a7"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2007.01.124"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02376.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T22:22:21Z","timestamp":1692310941000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,25]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/pan.14678"],"URL":"https:\/\/doi.org\/10.1111\/pan.14678","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,25]]},"assertion":[{"value":"2022-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}