CAM-ICU: Confusion Assessment Method for the ICU
2001CAM-ICU is a CAM-family bedside assessment adapted for critically ill adults, including patients who cannot give a conventional verbal response.
Classification
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Tool and original sources
View the official CAM-ICU worksheet and supporting materials on the Vanderbilt CIBS site.
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.
- 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.
- 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%.
Article PDF: CC BY. This licence applies to the article PDF and does not grant rights to reproduce the tool.
At a glance
- Purpose
- Episodic assessment
- Population
- Adult
- Setting
- Intensive care
- Time
- ~2 min
- Items
- 4
- 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 may be lower in routine practice than in research studies; performance depends on training, arousal and sedation state, communication constraints and correct administration
Evidence
Reported sensitivity and specificity
Original/source study · 2001 — pmid:11730446
- Denominator
- 96 patients
- Reference standard
- Independent delirium-expert DSM-IV assessment
Single original study (JAMA 2001; 96 participants): the displayed range spans two trained study nurses' first alert/lethargic paired assessments. See Compare for separately sourced pooled estimates.
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
- pooled
- Diagnostic-accuracy studies
- 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
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.
Sources checked 2026-07-24. How profiles are prepared.