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CSE: Confusional State Evaluation

1997

A 22-item observer-rated scale for grading the severity of delirium (confusional state) in older people and tracking its course over time.

At a glance

Purpose
Measurement of delirium severity
Population
Adult
Setting
General / acute hospital
Time
about 30 min (secondary NIDUS card; primary abstract does not report timing)
Items
22

Format: An observer-rated 22-item severity scale. Twelve items are summed to form the published confusion score; the remaining items add clinical description. Approximate timing comes from the linked NIDUS secondary card rather than the primary abstract.

  • Strengths: Tracks severity and course; confusion score correlated with psychogeriatrician global rating
  • Limitations: Single development/validation sample of older patients; not a case-finding test

Primary validation papers

0 identified diagnostic-accuracy papers

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

Large-scale clinical implementation

Not yet reviewed.

A focused implementation review has not yet been completed for this profile.

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

This record describes a method rather than a downloadable bedside form. The main source is linked below.

NIDUS information cards ↗

Original paper

  • Original paperRobertsson B, Karlsson I, Styrud E, Gottfries CG. Confusional State Evaluation (CSE): an instrument for measuring severity of delirium in the elderly. The British journal of psychiatry : the journal of mental science. 1997;170:565-70. doi: 10.1192/bjp.170.6.565. PMID: 9330025.

    This is the original published source for CSE. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
No eligible DTA study identifiedCore instrument family
Classification

Classification

Measurement of delirium severity

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Evidence

Diagnostic-accuracy evidenceNo eligible DTA study identified

Reported sensitivity and specificity

;
Sensitivity
;
Specificity

Severity scale; confusion score correlated r=0.79 with expert global rating (n=71).

More evidence and citation details
Full name
Confusional State Evaluation
Also known as
CSE
Evidence summary
psychometric-validation
Reliability
Weighted inter-rater kappa 0.38-0.93 across items
Citation
Robertsson B, Karlsson I, Styrud E, Gottfries CG Confusional State Evaluation (CSE): an instrument for measuring severity of delirium in the elderly The British journal of psychiatry : the journal of mental science. 1997;170:565-70. PMID 9330025
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.

No eligible diagnostic-accuracy paper is currently included in this audit. This does not mean the tool has never been validated. The source paper and other evidence on this profile may concern severity, reliability or another measurement purpose.

Copyright and reuse
Information checked
2026-07-19

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

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.