Testing the functional assessment of mentation: A mobile application based assessment of mental status

• Published in: Journal of hospital medicine Vol. 11; no. 7; pp. 463 - 466
• Main Authors: Hamilton, David E., Press, Valerie G., Twu, Nicole M., Yuen, Trevor C., Azu, Crystal N., Churpek, Matthew M., Edelson, Dana P.
• Format: Journal Article
• Language: English
• Published: United States Frontline Medical Communications 01.07.2016
• Subjects: Attention; Delirium - diagnosis; Delirium - psychology; Female; Hospitalization; Humans; Male; Mental Recall; Mental Status Schedule; Middle Aged; Mobile Applications - utilization; Pilot Projects; Prospective Studies
• ISSN: 1553-5592; 1553-5606
• DOI: 10.1002/jhm.2557

BACKGROUND Altered mental status is a significant predictor of mortality in hospitalized patients and a prerequisite component to the diagnosis of delirium. However, the detection of altered mental status is often incomplete, inaccurate, and resource intensive. OBJECTIVE To identify the clinical utility and feasibility of the Functional Assessment of Mentation (FAMTM), a mobile application for evaluating attention and recall. DESIGN Prospective observational pilot study. SETTING Tertiary care medical center. PARTICIPANTS Nine hundred thirty‐one adult subjects (612 nonhospitalized and 319 hospitalized). MEASUREMENTS Score distribution and time to FAMTM completion were compared between nonhospitalized and hospitalized subjects (as well as between hospitalized subjects discharged home and those not discharged home). Additionally, in the hospitalized subgroup, FAMTM was compared to the Glasgow Coma Scale (GCS), using the Short Portable Mental Status Questionnaire (SPMSQ) as our criterion standard for altered mental status assessment. RESULTS Median time to completion of FAMTM was 55 seconds (interquartile range [IQR], 45–67 seconds). Our data identified a graded reduction in score comparing nonhospitalized subjects to hospitalized subjects discharged home and not discharged home (median 5 [IQR 4–7] vs 5 [IQR 3–6] vs 3 [IQR 1–5]; P < 0.001). In the hospitalized subset, FAMTM scores were more highly correlated to SPMSQ (Spearman ρ = 0.27, P < 0.001) compared to GCS (Spearman ρ = 0.05, P = 0.40). CONCLUSIONS FAMTM is a rapid and clinically feasible tool that can identify minor alterations in mental status often missed by GCS. Journal of Hospital Medicine 2016;11:463–466. 2016 Society of Hospital Medicine