Strengths and limitations
delirium, DSM-5
BLIND
This is the first randomised controlled trial assessing the effect of music on delirium after craniotomy and the largest assessing the effect of music against delirium. We showed that music reduced the incidence of delirium when defined with the DOSS but not after DSM-5 confirmation. Our study was subject to several limitations: first, not all our patients with increased DOSS were evaluated by a psychiatrist due to logistics and we might have missed some patients with delirium. However, we feel that this did not affect our conclusions, because, with our low confirmation rate of suspected delirium, the study would still have been underpowered. Second, due to the nature of the intervention, we did not blind the study, which could have influenced the outcome assessors. However, blinding could not be secured which might have led to misleading results. Third, the generalisability of the results may be affected by the single-centre design of the study.