Development and feasibility of a smartphone-based test for the objective detection and monitoring of attention impairments in delirium in the ICU

Abstract Purpose Deliriumin the ICU is under-diagnosed. We evaluated feasibility and performance of a novel smartphone-based test for objectively detecting inattention in delirium. Material and methods DelApp-ICU combines a behavioural assessment and an attention task, whereby participants follow simple commands and count serially presented circles (score range 0–12, lower scores indicating worse performance). We assessed feasibility through staff interviews. Then we performed a preliminary case-control study in patients with and without delirium(ascertained with the Confusion Assessment Method for the ICU) who underwent the DelApp-ICU on up to 4 days. Results Forty-six patients (median age = 57.5 years, range 18–83) were assessed 89 times in total (N's = 46, 29, 10 and 4 for subsequent assessments; 33.7% delirious). DelApp-ICU scores were lower in delirium(N = 20; median = 0.5, Inter-Quartile Range (IQR) = 0–4.75) compared to no delirium(N = 26, median = 12, IQR = 8–12) on days 1, 2 and 3 (p  Conclusions DelApp-ICU shows promise for assessing inattention and deliriumin ICU patients, including longitudinally monitoring deficits and providing a metric of deliriumseverity.