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CAM-ICU: Confusion Assessment Method for the ICU

2001

CAM-ICU is a CAM-family bedside assessment adapted for critically ill adults, including patients who cannot give a conventional verbal response.

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
Intensive care, Perioperative
Time
~2 min
Diagnostic features
4, after an arousal check
Score or threshold
Feature-based classification after an arousal check; see the authorised materials.

Format: A brief ICU flowchart or worksheet beginning with an arousal check and then rating four CAM-family clinical features, with non-verbal methods where needed. The tasks, feature wording, thresholds and decision rule are not reproduced here.

  • Strengths: Validated for ventilated, non-verbal patients; fast
  • Limitations: Sensitivity is often lower in routine practice than in the original trained-research studies; performance depends on training, arousal and sedation, communication, neurological deficits and timing, so a negative assessment does not rule out delirium

Primary validation papers

49 identified diagnostic-accuracy papers

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

Reports identified: read the commentary

Selected primary reports and Penfold et al. (2024); not a completed census.

Training and instructions

  • CAM-ICU training manual. Public developer manual with instructions, case studies and FAQs.
  • CAM-ICU form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
  • CAM-ICU manual or instructions. Public manual or instructions checked on 5 September 2026. Follow the source’s version and permission conditions.
Start here

Tool and original sources

View the official CAM-ICU worksheet and supporting materials on the Vanderbilt CIBS site.

View the tool ↗ Official information and permissions ↗

Original and selected diagnostic-accuracy papers

  • Original paperEly EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286(21):2703-10. doi: 10.1001/jama.286.21.2703. PMID: 11730446.

    This paper reports the original validation of CAM-ICU. It reported sensitivity of 93–100% and specificity of 98–100% against an independent DSM-IV clinical assessment.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyEly EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Critical care medicine. 2001;29(7):1370-9. doi: 10.1097/00003246-200107000-00012. PMID: 11445689.

    This diagnostic-accuracy study evaluated CAM-ICU in adult medical and coronary ICUs of a tertiary university medical centre against an independent DSM-IV clinical assessment. It reported sensitivity of 95% and specificity of 93% in 38 ICU patients; 293 paired daily evaluations.

    Open PubMed ↗
  • Systematic review of diagnostic accuracyGusmao-Flores D, Salluh JI, Chalhub RÁ, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Critical care (London, England). 2012;16(4):R115. doi: 10.1186/cc11407. PMID: 22759376.

    This systematic review synthesised diagnostic-accuracy evidence for CAM-ICU. Across 9 studies involving 969 patients for CAM-ICU, pooled sensitivity was 80% and specificity was 95.9%.

    Open PubMed ↗Download article PDF ↓

    Article PDF: CC BY. This licence applies to the article PDF and does not grant rights to reproduce the tool.

Pooled diagnostic-accuracy evidenceCore instrument family
Classification

Classification

Episodic assessmentUse 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 evidencePooled diagnostic-accuracy evidence

Reported sensitivity and specificity

Headline metric source

Original/source study · 2001; pmid:11730446

Denominator
96 patients
Reference standard
Independent delirium-expert DSM-IV assessment
93–100%
Sensitivity
98–100%
Specificity

Original larger validation (JAMA 2001; 96 evaluable participants): the displayed range spans two trained study nurses' first alert or lethargic assessments. Later routine-practice studies and pooled estimates are shown below.

Expanded evidence profile

What the broader evidence shows

Interpretation: CAM-ICU is one of the best-studied adult intensive-care delirium tools and has consistently high pooled specificity, but sensitivity is lower and more variable than the original trained-research studies suggested. Routine performance depends on training, arousal and sedation, communication and neurological deficits, and timing; a negative assessment does not rule out delirium and repeat assessment plus clinical judgement remain important.

Evidence snapshots

  • Original larger validation (2001): For two trained study nurses, sensitivity was 100% and 93% and specificity 98% and 100% on first alert or lethargic assessments.
  • Routine multicentre nursing use (2011): Among 181 non-comatose patients, sensitivity was 47% and specificity 98%.
  • Cochrane diagnostic review (2023): Across 25 studies and 2,817 participants, pooled sensitivity was 78% and specificity 95%.
  • Intracerebral-haemorrhage cohort (2020): Across 257 daily assessments in 60 patients, CAM-ICU sensitivity was 41% and specificity 88%.

These results come from different populations and workflows and should not be averaged or treated as interchangeable.

9 selected PubMed-indexed papers, 2001–2026
  1. 2001Original development and validation study
    Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29(7):1370-1379. doi: 10.1097/00003246-200107000-00012. PMID: 11445689.

    The CAM was adapted for ventilated and often non-verbal intensive-care patients and evaluated in 38 patients through 293 paired daily assessments against delirium experts. Two study nurses achieved sensitivity of 95% and 96% with specificity of 93% for both, while an intensivist achieved sensitivity 100% and specificity 89%.

    PubMed · PMID 11445689 ↗
  2. 2001Original validation study
    Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286(21):2703-2710. doi: 10.1001/jama.286.21.2703. PMID: 11730446.

    This larger study enrolled 111 mechanically ventilated patients, with 96 evaluable and 471 paired assessments against independent delirium experts using DSM-IV criteria. On first alert or lethargic assessments, two trained study nurses achieved sensitivity of 100% and 93% and specificity of 98% and 100%, with inter-rater kappa 0.96.

    PubMed · PMID 11730446 ↗
  3. 2011Diagnostic-accuracy study
    van Eijk MM, van den Boogaard M, van Marum RJ, Benner P, Eikelenboom P, Honing ML, et al. Routine use of the confusion assessment method for the intensive care unit: a multicenter study. Am J Respir Crit Care Med. 2011;184(3):340-344. doi: 10.1164/rccm.201101-0065OC. PMID: 21562131.

    Expert teams assessed 282 patients in ten intensive-care units, excluded 101 who were comatose, and compared DSM-IV-TR classification with bedside nurses' routine CAM-ICU ratings in 181 patients. Sensitivity was 47% and specificity 98%, demonstrating a large research-to-routine sensitivity gap despite excellent specificity.

    PubMed · PMID 21562131 ↗
  4. 2012Systematic review and meta-analysis
    Gusmao-Flores D, Salluh JI, Chalhub RA, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012;16(4):R115. doi: 10.1186/cc11407. PMID: 22759376.

    This early diagnostic meta-analysis included nine CAM-ICU studies comprising 969 intensive-care patients assessed against DSM-IV criteria. Pooled sensitivity was 80.0% and specificity 95.9%, already lower in sensitivity than the original research studies.

    PubMed · PMID 22759376 ↗
  5. 2017Diagnostic-accuracy study
    Boettger S, Garcia Nuñez D, Meyer R, Richter A, Fernandez SF, Rudiger A, et al. Delirium in the intensive care setting: A reevaluation of the validity of the CAM-ICU and ICDSC versus the DSM-IV-TR in determining a diagnosis of delirium as part of the daily clinical routine. Palliat Support Care. 2017;15(6):675-683. doi: 10.1017/S1478951516001176. PMID: 28173895.

    In 210 patients with matched routine CAM-ICU, ICDSC and DSM-IV-TR assessments, delirium prevalence varied substantially by method. CAM-ICU sensitivity was 50% and specificity 95%, so a negative routine result did not exclude delirium.

    PubMed · PMID 28173895 ↗
  6. 2020Diagnostic-accuracy study
    Reznik ME, Drake J, Margolis SA, Moody S, Murray K, Costa S, et al. Deconstructing Poststroke Delirium in a Prospective Cohort of Patients With Intracerebral Hemorrhage. Crit Care Med. 2020;48(1):111-118. doi: 10.1097/CCM.0000000000004031. PMID: 31567406.

    A neurointensivist completed 257 daily reference-standard assessments in 60 patients with intracerebral haemorrhage, many of whom had aphasia or features that could not be assessed verbally. CAM-ICU sensitivity was 41% and specificity 88%, compared with 77% and 97% for ICDSC in this single neurological cohort.

    PubMed · PMID 31567406 ↗
  7. 2021Systematic review and meta-analysis
    Chen TJ, Chung YW, Chang HR, Chen PY, Wu CR, Hsieh SH, et al. Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: A bivariate meta-analysis. Int J Nurs Stud. 2021;113:103782. doi: 10.1016/j.ijnurstu.2020.103782. PMID: 33120134.

    This bivariate meta-analysis identified 29 CAM-ICU studies and used random-effects methods to synthesise diagnostic accuracy. Pooled sensitivity was 84% and specificity 95%, with performance moderated by hypoactive delirium, intensive-care type, ventilation and sample characteristics.

    PubMed · PMID 33120134 ↗
  8. 2023Systematic review and meta-analysis
    Miranda F, Gonzalez F, Plana MN, Zamora J, Quinn TJ, Seron P. Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings. Cochrane Database Syst Rev. 2023;11(11):CD013126. doi: 10.1002/14651858.CD013126.pub2. PMID: 37987526.

    This Cochrane diagnostic-test-accuracy review included 25 studies with 2,817 adult critical-care participants, 13 of which were judged low risk across all QUADAS-2 domains. Pooled sensitivity was 78% and specificity 95%; restricting analysis to the 13 low-risk studies produced sensitivity 80% and specificity 95%.

    PubMed · PMID 37987526 ↗
  9. 2026Systematic review and meta-analysis
    Li N, Zhou Z, Yao T, Xu X. Diagnostic Accuracy of Screening Tools for Delirium in Adults Receiving Care in Intensive Care Units: A Systematic Review and Network Meta-Analysis. Nurs Health Sci. 2026;28(2):e70344. doi: 10.1111/nhs.70344. PMID: 42077053.

    This network meta-analysis included 50 studies and 6,042 patients across several adult intensive-care delirium tools. It reported CAM-ICU specificity of 94.9% and described it as widely used, but the PubMed abstract does not provide a CAM-ICU-specific pooled sensitivity.

    PubMed · PMID 42077053 ↗

This is a selected evidence overview, not a systematic review. Nine papers were chosen to contrast the two foundational 2001 studies with routine-practice, neurocritical-care and pooled evidence through 2026; all nine records were checked in PubMed and Scite on 30 August 2026, and no selected record surfaced under the retraction, concern, correction or erratum filters used.

More evidence and citation details
Full name
Confusion Assessment Method for the ICU
Related profiles
CAM-ICU-10, CAM-ICU-7, CAM-ICU Flowsheet, CAM-ICU Plus
Training
Users should work through the official CAM-ICU training manual and become competent in the accompanying arousal assessment and CAM-ICU procedure; no psychiatric qualification is required.
Evidence summary
Systematic reviews and multiple diagnostic-accuracy studies
Diagnostic-accuracy evaluations
50
Reference standard
DSM-IV (delirium experts)
Reliability
Inter-rater κ 0.96
Citation
Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) JAMA. 2001;286(21):2703-10. PMID 11730446
Download RIS ↗ Download BibTeX ↗

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 49 identified papers
  1. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, Speroff T, Gautam S, Bernard GR, Inouye SK (2001). Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Critical care medicine.

    Reference category: independent clinical reference.

  2. Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R (2001). Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA.

    Reference category: independent clinical reference.

  3. Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, Fang YF, Shieh MH, Kuo HP (2004). The impact of delirium on the survival of mechanically ventilated patients. Critical care medicine.

    Reference category: independent clinical reference.

  4. McNicoll L, Pisani MA, Ely EW, Gifford D, Inouye SK (2005). Detection of delirium in the intensive care unit: comparison of confusion assessment method for the intensive care unit with confusion assessment method ratings. Journal of the American Geriatrics Society.

    Reference category: other comparator or secondary accuracy evidence.

  5. Chuang WL, Lin CH, Hsu WC, Ting YJ, Lin KC, Ma SC (2007). [Evaluation of the reliability and validity of the Chinese version of the confusion assessment method for the intensive care unit]. Hu li za zhi The journal of nursing.

    Reference category: other comparator or secondary accuracy evidence.

  6. van Eijk MM, van Marum RJ, Klijn IA, de Wit N, Kesecioglu J, Slooter AJ (2009). Comparison of delirium assessment tools in a mixed intensive care unit. Critical care medicine.

    Reference category: independent clinical reference.

  7. Tobar E, Romero C, Galleguillos T, Fuentes P, Cornejo R, Lira MT, de la Barrera L, Sánchez JE, Bozán F, Bugedo G, Morandi A, Ely WE (2010). [Confusion Assessment Method for diagnosing delirium in ICU patients (CAM-ICU): cultural adaptation and validation of the Spanish version]. Medicina intensiva.

    Reference category: independent clinical reference.

  8. Guenther U, Popp J, Koecher L, Muders T, Wrigge H, Ely EW, Putensen C (2010). Validity and reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients. Journal of critical care.

    Reference category: independent clinical reference.

  9. Luetz A, Heymann A, Radtke FM, Chenitir C, Neuhaus U, Nachtigall I, von Dossow V, Marz S, Eggers V, Heinz A, Wernecke KD, Spies CD (2010). Different assessment tools for intensive care unit delirium: which score to use?. Critical care medicine.

    Reference category: independent clinical reference.

  10. Toro AC, Escobar LM, Franco JG, Díaz-Gómez JL, Muñoz JF, Molina F, Bejarano J, Yepes D, Navarro E, García A, Ely WE, Esteban A (2010). [Spanish version of the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit). Pilot study of validation]. Medicina intensiva.

    Reference category: independent clinical reference.

  11. Neufeld KJ, Hayat MJ, Coughlin JM, Huberman AL, Leistikow NA, Krumm SK, Needham DM (2011). Evaluation of two intensive care delirium screening tools for non-critically ill hospitalized patients. Psychosomatics.

    Reference category: independent clinical reference.

  12. van Eijk MM, van den Boogaard M, van Marum RJ, Benner P, Eikelenboom P, Honing ML, van der Hoven B, Horn J, Izaks GJ, Kalf A, Karakus A, Klijn IA, Kuiper MA, de Leeuw FE, de Man T, van der Mast RC, Osse RJ, de Rooij SE, Spronk PE, van der Voort PH, van Gool WA, Slooter AJ (2011). Routine use of the confusion assessment method for the intensive care unit: a multicenter study. American journal of respiratory and critical care medicine.

    Reference category: independent clinical reference.

  13. Heo EY, Lee BJ, Hahm BJ, Song EH, Lee HA, Yoo CG, Kim YW, Han SK, Shim YS, Lee SM (2011). Translation and validation of the Korean Confusion Assessment Method for the Intensive Care Unit. BMC psychiatry.

    Reference category: independent clinical reference.

  14. Gusmao-Flores D, Salluh JI, Dal-Pizzol F, Ritter C, Tomasi CD, Lima MA, Santana LR, Lins RM, Lemos PP, Serpa GV, Oliveira J, Chalhub RÁ, Pitrowsky MT, Lacerda AL, Koenen KC, Quarantini LC (2011). The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients. Clinics (Sao Paulo, Brazil).

    Reference category: independent clinical reference.

  15. Vasilevskis EE, Morandi A, Boehm L, Pandharipande PP, Girard TD, Jackson JC, Thompson JL, Shintani A, Gordon SM, Pun BT, Ely EW (2011). Delirium and sedation recognition using validated instruments: reliability of bedside intensive care unit nursing assessments from 2007 to 2010. Journal of the American Geriatrics Society.

    Reference category: other comparator or secondary accuracy evidence.

  16. Mitasova A, Kostalova M, Bednarik J, Michalcakova R, Kasparek T, Balabanova P, Dusek L, Vohanka S, Ely EW (2012). Poststroke delirium incidence and outcomes: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Critical care medicine.

    Reference category: independent clinical reference.

  17. Adamis D, Dimitriou C, Anifantaki S, Zachariadis A, Astrinaki I, Alegakis A, Mari H, Tsiatsiotis N (2012). Validation of the Greek version of Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Intensive & critical care nursing.

    Reference category: independent clinical reference.

  18. Wang C, Wu Y, Yue P, Ely EW, Huang J, Yang X, Liu Y (2013). Delirium assessment using Confusion Assessment Method for the Intensive Care Unit in Chinese critically ill patients. Journal of critical care.

    Reference category: independent clinical reference.

  19. Powers JS, Doering T, Gordon S, Eden SK, Shintani A, Schnelle J (2013). Exploring the utility of ultra-brief delirium assessments in a nonintensive care geriatric population: the GEM study. The Gerontologist.

    Reference category: other comparator or secondary accuracy evidence.

  20. Neufeld KJ, Leoutsakos JS, Sieber FE, Joshi D, Wanamaker BL, Rios-Robles J, Needham DM (2013). Evaluation of two delirium screening tools for detecting post-operative delirium in the elderly. British journal of anaesthesia.

    Reference category: independent clinical reference.

  21. Han JH, Wilson A, Graves AJ, Shintani A, Schnelle JF, Dittus RS, Powers JS, Vernon J, Storrow AB, Ely EW (2014). Validation of the Confusion Assessment Method for the Intensive Care Unit in older emergency department patients. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

    Reference category: independent clinical reference.

  22. Pipanmekaporn T, Wongpakaran N, Mueankwan S, Dendumrongkul P, Chittawatanarat K, Khongpheng N, Duangsoy N (2014). Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Clinical interventions in aging.

    Reference category: independent clinical reference.

  23. Koga Y, Tsuruta R, Murata H, Matsuo K, Ito T, Ely EW, Shintani A, Wakamatsu H, Sanui M, Yamase H (2015). Reliability and validity assessment of the Japanese version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Intensive & critical care nursing.

    Reference category: independent clinical reference.

  24. Kuczmarska A, Ngo LH, Guess J, O'Connor MA, Branford-White L, Palihnich K, Gallagher J, Marcantonio ER (2016). Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU. Journal of general internal medicine.

    Reference category: independent clinical reference.

  25. Nishimura K, Yokoyama K, Yamauchi N, Koizumi M, Harasawa N, Yasuda T, Mimura C, Igita H, Suzuki E, Uchiide Y, Seino Y, Nomura M, Yamazaki K, Ishigooka J, TMAD investigators (2016). Sensitivity and specificity of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium: A single-center study in Japan. Heart & lung : the journal of critical care.

    Reference category: independent clinical reference.

  26. Van de Meeberg EK, Festen S, Kwant M, Georg RR, Izaks GJ, Ter Maaten JC (2017). Improved detection of delirium, implementation and validation of the CAM-ICU in elderly Emergency Department patients. European journal of emergency medicine : official journal of the European Society for Emergency Medicine.

    Reference category: independent clinical reference.

  27. Koskderelioglu A, Onder O, Gucuyener M, Altay T, Kayali C, Gedizlioglu M (2017). Screening for postoperative delirium in patients with acute hip fracture: Assessment of predictive factors. Geriatrics & gerontology international.

    Reference category: independent clinical reference.

  28. Boettger S, Nuñez DG, Meyer R, Richter A, Fernandez SF, Rudiger A, Schubert M, Jenewein J (2017). Delirium in the intensive care setting: A reevaluation of the validity of the CAM-ICU and ICDSC versus the DSM-IV-TR in determining a diagnosis of delirium as part of the daily clinical routine. Palliative & supportive care.

    Reference category: independent clinical reference.

  29. Barman A, Pradhan D, Bhattacharyya P, Dey S, Bhattacharjee A, Tesia SS, Mitra JK (2018). Diagnostic accuracy of delirium assessment methods in critical care patients. Journal of critical care.

    Reference category: other comparator or secondary accuracy evidence.

  30. Selim A, Kandeel N, Elokl M, Khater MS, Saleh AN, Bustami R, Ely EW (2018). The validity and reliability of the Arabic version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU): A prospective cohort study. International journal of nursing studies.

    Reference category: independent clinical reference.

  31. Chanques G, Ely EW, Garnier O, Perrigault F, Eloi A, Carr J, Rowan CM, Prades A, de Jong A, Moritz-Gasser S, Molinari N, Jaber S (2018). The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists. Annals of intensive care.

    Reference category: independent clinical reference.

  32. Aljuaid MH, Deeb AM, Dbsawy M, Alsayegh D, Alotaibi M, Arabi YM (2018). Psychometric properties of the Arabic version of the confusion assessment method for the intensive care unit (CAM-ICU). BMC psychiatry.

    Reference category: independent clinical reference.

  33. Larsen LK, Frøkjaer VG, Nielsen JS, Skrobik Y, Winkler Y, Møller K, Petersen M, Egerod I (2019). Delirium assessment in neuro-critically ill patients: A validation study. Acta anaesthesiologica Scandinavica.

    Reference category: independent clinical reference.

  34. Danzeng QZ, Cui N, Wang H, Pan WJ, Long Y, Deji YZ, Ze C, Ren Z (2019). Translation and validation of the Tibetan confusion assessment method for the intensive care unit. Chinese medical journal.

    Reference category: independent clinical reference.

  35. Wongviriyawong T, Sura-Arunsumrit P, Chaiwat O, To-Adithep P, Ramlee R, Srinonprasert V (2019). Diagnosis of postoperative delirium in older adults using the Confusion Assessment Method for the intensive care unit in non-intensive care unit settings: A test modification might improve its diagnostic performance. Geriatrics & gerontology international.

    Reference category: independent clinical reference.

  36. Reznik ME, Drake J, Margolis SA, Moody S, Murray K, Costa S, Mahta A, Wendell LC, Thompson BB, Rao SS, Barrett AM, Boukrina O, Daiello LA, Asaad WF, Furie KL, Jones RN (2020). Deconstructing Poststroke Delirium in a Prospective Cohort of Patients With Intracerebral Hemorrhage. Critical care medicine.

    Reference category: independent clinical reference.

  37. Klankluang W, Pukrittayakamee P, Atsariyasing W, Siriussawakul A, Chanthong P, Tongsai S, Tayjasanant S (2020). Validity and Reliability of the Memorial Delirium Assessment Scale-Thai Version (MDAS-T) for Assessment of Delirium in Palliative Care Patients. The oncologist.

    Reference category: independent clinical reference.

  38. von Hofen-Hohloch J, Awissus C, Fischer MM, Michalski D, Rumpf JJ, Classen J (2020). Delirium Screening in Neurocritical Care and Stroke Unit Patients: A Pilot Study on the Influence of Neurological Deficits on CAM-ICU and ICDSC Outcome. Neurocritical care.

    Reference category: independent clinical reference.

  39. Ben Saida I, Kortli S, Amamou B, Kacem N, Ghardallou M, Ely EW, Ben Saad H, Boussarsar M (2020). A Tunisian version of the confusion assessment method for the intensive care unit (CAM-ICU): translation and validation. BMC psychiatry.

    Reference category: independent clinical reference.

  40. Nacul FE, Paul N, Spies CD, Sechting H, Hecht T, Dullinger JS, Piper SK, Luetz A, Balzer FS, Wernecke KD, Sa AK, Barros Ferreira da Costa C, Eymold L, Chenitir C, Weiss B (2020). Influence of Sedation Level and Ventilation Status on the Diagnostic Validity of Delirium Screening Tools in the ICU-An International, Prospective, Bi-Center Observational Study (IDeAS). Medicina (Kaunas, Lithuania).

    Reference category: independent clinical reference.

  41. Sutt AL, Flaws D, Gunn H, Eeles E, Lye I, Irvine L, Patterson S, Bagshaw T, O'Luanaigh C, Tronstad O, Fraser J (2021). Screening for delirium in the intensive care unit using eDIS-ICU - A purpose-designed app: A pilot study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.

    Reference category: independent clinical reference.

  42. Weiss B, Paul N, Spies CD, Ullrich D, Ansorge I, Salih F, Wolf S, Luetz A (2022). Influence of Patient-Specific Covariates on Test Validity of Two Delirium Screening Instruments in Neurocritical Care Patients (DEMON-ICU). Neurocritical care.

    Reference category: independent clinical reference.

  43. Hur HJ, Jang YN, Park HY, Lee YS, Ro DH, Kang B, Song KH, Park HY (2022). A prospective study of remote delirium screening using the modified K-4AT for COVID-19 inpatients. Frontiers in psychiatry.

    Reference category: independent clinical reference.

  44. Alaterre C, Fazilleau C, Cayot-Constantin S, Chanques G, Kacer S, Constantin JM, James A (2023). Monitoring delirium in the intensive care unit: Diagnostic accuracy of the CAM-ICU tool when performed by certified nursing assistants - A prospective multicenter study. Intensive & critical care nursing.

    Reference category: other comparator or secondary accuracy evidence.

  45. Bakošová L, Kec D, Škorňa M, Jura R, Kundrata Z, Košťálová M, Bednařík J (2024). Screening and differential diagnosis of delirium in neurointensive stroke patients. Heliyon.

    Reference category: independent clinical reference.

  46. Salhotra R, Bose A, Srivastava S, Mohta M, Pandarinathan K, Rautela RS (2024). Reliability and Validity of Hindi Version of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) for Diagnosis of Delirium: A Cohort Study. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine.

    Reference category: independent clinical reference.

  47. Breit H, Panos NG, Fisher K, Blackwood A, Yeager C, Schachter M, Michalopoulos G, Petry LG, Da Silva I, John S (2025). Delirium screening in the neurointensive care unit: Comparison of the confusion assessment method for the intensive care unit and intensive care delirium screening checklist. Journal of the neurological sciences.

    Reference category: other comparator or secondary accuracy evidence.

  48. Somarajan D, Prakash R, Chellamma J, Shelley NS, Anand A, James TG, Mangalanandan N, Mathews AM, Fletcher NE (2026). Diagnostic Accuracy of CAM-ICU and ICDSC for Detection of Early Delirium in Acute Ischemic Stroke: A Cross-sectional Study. Annals of Indian Academy of Neurology.

    Reference category: independent clinical reference.

  49. Veiga CCNT, Marques PAO, Dias JMM, Carvalho AAS (2026). Validation of the confusion assessment method for intensive care. Open medicine (Warsaw, Poland).

    Reference category: other comparator or secondary accuracy evidence.

Copyright and reuse
Version
Current CIBS flowsheet (2023 PDF when checked)
Rights holder
E. Wesley Ely, MD, MPH and Vanderbilt University
Licence
CLINICAL-IMPLEMENTATION-PERMISSION-NOT-OPEN-LICENCE
Information checked
2026-07-19

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

Base clinical review: 2026-08-30. Instrument description source check: 2026-09-05. Scope and limitations.