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3D-CAM

2014

3D-CAM is a short structured interview with 20 core interview and observer-rated items plus two conditional supplementary items. It operationalises the CAM clinical features to assess for current delirium in hospitalised adults, including people living with dementia.

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Classification

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Tool and original sources

View the current 3D-CAM at Delirium Central. Permission is required for reproduction, so it is not reproduced here.

Original and selected diagnostic-accuracy papers

  • Original paperMarcantonio ER, Ngo LH, O'Connor M, Jones RN, Crane PK, Metzger ED, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study. Annals of internal medicine. 2014;161(8):554-61. doi: 10.7326/M14-0865. PMID: 25329203.

    This paper reports the derivation and initial validation of 3D-CAM. It reported sensitivity of 95% and specificity of 94% against an independent DSM-IV clinical assessment.

  • Selected diagnostic-accuracy studyKuczmarska A, Ngo LH, Guess J, O'Connor MA, Branford-White L, Palihnich K, et al. Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU. Journal of general internal medicine. 2016;31(3):297-303. doi: 10.1007/s11606-015-3514-0. PMID: 26443577.

    This diagnostic-accuracy study evaluated 3D-CAM in two non-ICU general-medicine units at one academic medical centre against an independent DSM-IV clinical assessment. It reported sensitivity of 95% and specificity of 93% in 101 hospitalised patients aged 75 years or older.

  • Selected diagnostic-accuracy studyOlbert M, Eckert S, Mörgeli R, Kruppa J, Spies CD. Validation of 3-minute diagnostic interview for CAM-defined Delirium to detect postoperative delirium in the recovery room: A prospective diagnostic study. European journal of anaesthesiology. 2019;36(9):683-687. doi: 10.1097/EJA.0000000000001048. PMID: 31306183.

    This diagnostic-accuracy study evaluated 3D-CAM in recovery room of a tertiary university hospital against a DSM-5 clinical assessment. It reported sensitivity of 100% and specificity of 88% in 176 adult elective-surgery patients; 16 postoperative-delirium cases.

Pooled diagnostic-accuracy evidenceCore instrument family

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
General / acute hospital
Time
~3 min
Items
20
Score or threshold
Operationalised CAM algorithm

Format: The validated 3D-CAM assessment contains 20 core interview and observer-rated items covering the four CAM clinical features. The current official form also includes two conditional supplementary items. Administration takes about 3 minutes. The prompts, response options, feature scoring and decision rule are not reproduced here; use the linked official materials.

  • Strengths: Operationalises all four CAM features in ~3 min; strong in dementia
  • Limitations: The base assessment should not be conflated with the separately derived 3D-CAM-S severity method

Evidence

Evidence maturityPooled diagnostic-accuracy evidence

Reported sensitivity and specificity

Headline metric source

Original/source study · 2014 — pmid:25329203

Denominator
Reported source unit: 201 (analysis unit not fully reconciled)
Reference standard
Face-to-face clinical assessment plus record/nurse/family information and MoCA, followed by expert-panel DSM-IV adjudication
95%
Sensitivity
94%
Specificity

Original validation, n=201; against expert reference standard.

More evidence and citation details
Full name
3D-CAM
Also known as
3-minute CAM, 3 minute diagnostic CAM
Training
Use the current 3D-CAM manual and recommended training before clinical or research use.
Evidence summary
pooled
Diagnostic-accuracy studies
9
Reference standard
Expert panel
Citation
Marcantonio ER, Ngo LH, O'Connor M, Jones RN, Crane PK, Metzger ED, Inouye SK 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study Annals of internal medicine. 2014;161(8):554-61. PMID 25329203
Copyright and reuse
Version
3D-CAM version 5.7
Rights holder
Hospital Elder Life Program (copyright); Aging Brain Center (permissions administrator)
Licence
ALL-RIGHTS-RESERVED-PERMISSION-REQUIRED
Information checked
2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Sources checked 2026-07-29. How profiles are prepared.