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bCAM: Brief Confusion Assessment Method

2013

bCAM is a brief CAM-family assessment developed for older emergency-department patients. It may be used alone or within a locally selected workflow.

Classification

Classification

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Tool and original sources

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Original and selected diagnostic-accuracy papers

  • Original paperHan JH, Wilson A, Vasilevskis EE, Shintani A, Schnelle JF, Dittus RS, et al. Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. Annals of emergency medicine. 2013;62(5):457-465. doi: 10.1016/j.annemergmed.2013.05.003. PMID: 23916018.

    This paper reports the original validation of bCAM. It is the main source for the method, its intended use and the evidence available at publication.

  • Selected diagnostic-accuracy studyHendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, et al. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age and ageing. 2016;45(6):832-837. doi: 10.1093/ageing/afw130. PMID: 27503794.

    This diagnostic-accuracy study evaluated bCAM in geriatric medical assessment unit of an urban teaching hospital against a DSM-5 clinical assessment. It reported sensitivity of 70.3% and specificity of 91.4% in 387 patients with complete bCAM data within a 500-patient consecutive cohort.

  • Selected diagnostic-accuracy studyBaten V, Busch HJ, Busche C, Schmid B, Heupel-Reuter M, Perlov E, et al. Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2018;25(11):1251-1262. doi: 10.1111/acem.13449. PMID: 29738102.

    This diagnostic-accuracy study evaluated bCAM in german interdisciplinary high-volume emergency department against a DSM-5 clinical assessment. It reported sensitivity of 65.2% and specificity of 93.8% in 288 non-surgical medical patients aged 70 years or older.

Multiple DTA studies identifiedCore instrument family

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
Emergency department
Time
<2 min
Items
4
Score or threshold
Feature-based CAM-family classification; see the authorised materials.

Format: A brief emergency-department CAM-family assessment combining a short cognitive assessment with four clinical feature ratings. It is often used after a sensitive first-step screen; tasks and decision logic are not reproduced here.

  • Strengths: Fast, more-specific follow-up assessment for the ED
  • Limitations: Lower sensitivity than the paired DTS; no result is definitive on its own

Evidence

Evidence maturityMultiple DTA studies identified

Reported sensitivity and specificity

78–84%
Sensitivity
96–97%
Specificity

Original validation, n=406; physician and RA raters.

More evidence and citation details
Full name
Brief Confusion Assessment Method
Also known as
bCAM
Related profiles
DTS, DTS/bCAM combination
Evidence summary
multi
Diagnostic-accuracy studies
5
Reference standard
DSM-IV-TR (psychiatrist)
Real-world use
In one large report, completion ranged from 12% in labour/delivery to 98% on medical services during phased implementation; setting and implementation stage both differed. (Penfold 2024)
Citation
Han JH, Wilson A, Vasilevskis EE, Shintani A, Schnelle JF, Dittus RS, Graves AJ, Storrow AB, Shuster J, Ely EW Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method Annals of emergency medicine. 2013;62(5):457-465. PMID 23916018
Copyright and reuse
Version
CIBS-hosted bCAM flowsheet
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.