A guide to the directory

A map of delirium tools

Start with the question you need a tool to answer. Select an island or read the groups below.

This is a visual guide, not a definitive classification. Some tools belong to more than one category.

The position and size of each island do not indicate the strength of evidence.

Episodic assessment

Assess possible delirium now.

A structured assessment at a particular point in time. It may be repeated when clinically indicated. The required interview, cognitive tests and history remain part of the procedure.

Examples: 4AT, CAM, 3D-CAM, bCAM, CAM-ICU.

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Monitoring

Notice new or changing features during care.

Observation over time can prompt assessment. The best tool, frequency and response pathway are not settled. A monitoring score should not delay action on a new concern.

Examples: NuDESC, DOSS, RADAR.

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Severity

Measure the extent of delirium symptoms.

Severity ratings can describe change and support research. They measure a different outcome from a yes-or-no delirium assessment. Some instruments serve both purposes.

Examples: DRS-R-98, MDAS, CAM-S.

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Ultra-brief tools

Identify a reason for fuller assessment.

A very short test or question can form the first stage of a pathway. A positive result often needs a second assessment. A negative result must be interpreted in context.

Examples: UB-2, SQiD, DTS.

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Arousal

Describe alertness or responsiveness.

Arousal is important in delirium assessment, but an arousal score alone does not establish delirium. RASS also has an established role in assessing agitation and sedation in intensive care.

Examples: mRASS, OSLA.

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Distress and experience

Understand what delirium is like for people.

These instruments address distress, recall or experience. The respondent may be a patient, family member or staff member. Timing and ability to give an account matter.

Examples: DEQ, TDDS.

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Cognitive tests

Examine attention and other cognitive functions.

Tests and batteries can help characterise cognitive impairment. Results need clinical context: an abnormal cognitive score alone cannot distinguish delirium from dementia or other causes.

Examples: CTD, DelApp.

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Other ways to find a tool

These seven groups are a starting point. Setting, age, information source and purpose overlap. The full directory also covers motor subtype, retrospective assessment, aetiology and related methods.

See where assessment fits into the patient journey