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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.

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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.

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.

  • 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.

One DTA study identifiedVersion or adaptation

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.

Evidence

Evidence maturityOne 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 studies
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
Copyright and reuse
Information checked
2026-07-19

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

Sources checked 2026-07-24. How profiles are prepared.