CAM-ICU-7: Confusion Assessment Method for the ICU-7

2017

An ICU delirium-severity score derived from the four CAM-ICU feature domains together with level of arousal. The 7 in its name is the upper end of the score, not an item count.

At a glance

Purpose: Measurement of delirium severity
Population: Adult
Setting: Intensive care
Time: ~2 min
Score or threshold: 0–7 severity score; ≥3 was the diagnostic threshold in the 2024 evaluation

Format: CAM-ICU-7 converts information already gathered during CAM-ICU and RASS assessment into a severity total from 0 to 7. It does not contain seven independent questions and it does not replace the underlying delirium assessment. Use the authorised CAM-ICU materials and the published severity method rather than reconstructing the score from this summary.

Strengths: Severity grading in the ICU
Limitations: The 2024 diagnostic evaluation was a COVID-era, single-centre study with repeated assessments, many missing or excluded assessments and few severe-delirium cases. Its paper contains internal inconsistencies in the reported accuracy values and assessment denominators.

Training and instructions

Public training resources have not yet been confirmed in this review. Check the linked developer or original source for instructions.

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Tool and original sources

No direct copy is linked here. The original paper and a Google Images search are available below. Image results may be unofficial; check the version and source before use.

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Original and selected diagnostic-accuracy papers

Original paperKhan BA, Perkins AJ, Gao S, Hui SL, Campbell NL, Farber MO, et al. The Confusion Assessment Method for the ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU. Critical care medicine. 2017;45(5):851-857. doi: 10.1097/CCM.0000000000002368. PMID: 28263192.
This is the original published source for CAM-ICU-7. It is the main source for the method, its intended use and the evidence available at publication.
Open PubMed ↗
Selected diagnostic-accuracy studyvan den Boogaard M, Leenders M, Pop-Purceleanu M, Tilburgs B. Performance and validation of two ICU delirium assessment and severity tools; a prospective observational study. Intensive & critical care nursing. 2024;83:103627. doi: 10.1016/j.iccn.2024.103627. PMID: 38301387.
This diagnostic-accuracy study evaluated CAM-ICU-7 in adult intensive care in routine clinical practice against dRS-R98 assessment by delirium experts. It reported sensitivity of 90% and specificity of 92.4% in 104 CAM-ICU-7 assessments in 86 ICU patients.
Open PubMed ↗

One DTA study identifiedVersion or adaptation

Classification

Measurement of delirium severity Use in intensive care units

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceOne DTA study identified

Reported sensitivity and specificity

Headline metric source

Later validation or evaluation · 2024; pmid:38301387

Denominator: 86 patients; 104 assessments
Reference standard: DRS-R98 >15 assessed by delirium experts

≈90%

Sensitivity

≈91–92%

Specificity

Approximate diagnostic-performance summary from the 2024 evaluation of 86 patients, with 104 completed matched CAM-ICU-7 assessments. The paper's abstract and results narrative report 90% sensitivity and 92.4% specificity, whereas Table 2 reports mean values of 89.5% and 91.4%. Do not present one exact pair without this qualification or derive a 2 x 2 table. The 2017 cohort of 518 supports severity reliability, construct and outcome validity, not these estimates.

More evidence and citation details

Full name: Confusion Assessment Method for the ICU-7
Also known as: CAM-ICU-7
Related profiles: CAM-ICU
Training: Users should be competent in CAM-ICU and RASS and follow the authorised materials. In the 2024 study, more than 80% of nurses received a 30-minute refresher in a unit where CAM-ICU had been established since 2007.
Evidence summary: single-DTA
Diagnostic-accuracy evaluations: 1
Reference standard: DRS-R98 >15 assessed by delirium experts
Source-study sample: 518 patients; 2017 · pmid:28263192; severity development, reliability, construct validity and outcome association
Reliability: α 0.85
Citation: Khan BA, Perkins AJ, Gao S, Hui SL, Campbell NL, Farber MO, Chlan LL, Boustani MA The Confusion Assessment Method for the ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU Critical care medicine. 2017;45(5):851-857. PMID 28263192

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Primary validation studies

Distinct primary publications from the current diagnostic-accuracy audit. Reviews and repeated evaluations within one paper are not counted again. Overlapping cohorts have not all been reconciled. Read the counting rules and limitations.

Open 1 identified paper

van den Boogaard M, Leenders M, Pop-Purceleanu M, Tilburgs B (2024). Performance and validation of two ICU delirium assessment and severity tools; a prospective observational study. Intensive & critical care nursing.
Reference category: other comparator or secondary accuracy evidence.

Information checked: 2026-07-19

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

Base clinical review: 2026-07-24. Instrument description source check: 2026-09-05. Scope and limitations.

CAM-ICU-7: Confusion Assessment Method for the ICU-7

At a glance

Primary validation papers

Large-scale clinical implementation