CTD: Cognitive Test for Delirium

1996

A cognitive battery developed for medical ICU patients, with responses that can be given without speech. It assesses orientation, attention, memory, comprehension and vigilance.

At a glance

Purpose: Domain-specific or adjunctive measure
Population: Adult
Setting: Intensive care, General / acute hospital
Time: ~10–15 min
Content items: 9, grouped into 5 scored domains
Score or threshold: Total 0–30; lower scores indicate greater cognitive impairment. Diagnostic thresholds are study-specific.

Format: Nine numbered content items contribute to five domain scores, each ranging from 0 to 6, for a total of 0 to 30. Some items contain several questions or trials. This is an administered cognitive battery, not passive observation. The original procedure requires test materials, including a separate visual memory span test.

Training and instructions

CTD form. English form in the Belgian clinical archive. The original test also needs separate visual memory span materials; this PDF is not a complete test kit.

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Tool and original sources

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Original and selected diagnostic-accuracy papers

Original paperHart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics. 1996;37(6):533-46. doi: 10.1016/S0033-3182(96)71517-7. PMID: 8942204.
This paper reports the original validation of CTD. It reported sensitivity of 100% and specificity of 95% against pre-existing diagnostic-group membership; no independently applied delirium reference standard reported.
Open PubMed ↗
Selected diagnostic-accuracy studyKennedy RE, Nakase-Thompson R, Nick TG, Sherer M. Use of the cognitive test for delirium in patients with traumatic brain injury. Psychosomatics. 2003;44(4):283-9. doi: 10.1176/appi.psy.44.4.283. PMID: 12832593.
This diagnostic-accuracy study evaluated CTD in neurorehabilitation centre against a DSM-IV clinical assessment. It reported sensitivity of 72% and specificity of 71% in 65 consecutive traumatic-brain-injury patients; 249 complete weekly observations.
Open PubMed ↗

Multiple DTA studies identifiedCore instrument family

Classification

Domain-specific or adjunctive measureCognitive tests designed for delirium Detailed phenomenological and/or neuropsychological assessment Use in intensive care units

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Evidence

Diagnostic-accuracy evidenceMultiple DTA studies identified

Reported sensitivity and specificity

Headline metric source

Original/source study · 1996; pmid:8942204

Denominator: Reported source unit: 103 (analysis unit not fully reconciled)
Reference standard: Pre-existing diagnostic-group membership; no independently applied delirium reference standard reported

100%

Sensitivity

95%

Specificity

Original validation; optimal cut-off.

More evidence and citation details

Full name: Cognitive Test for Delirium
Also known as: CTD
Related profiles: aCTD
Evidence summary: multi
Diagnostic-accuracy evaluations: 2
Reference standard: Pre-existing diagnostic-group membership; no independently applied delirium reference standard reported
Citation: Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE Validation of a cognitive test for delirium in medical ICU patients Psychosomatics. 1996;37(6):533-46. PMID 8942204

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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 2 identified papers

Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE (1996). Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics.
Reference category: other comparator or secondary accuracy evidence.
Kennedy RE, Nakase-Thompson R, Nick TG, Sherer M (2003). Use of the cognitive test for delirium in patients with traumatic brain injury. Psychosomatics.
Reference category: independent clinical reference.

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.

CTD: Cognitive Test for Delirium

At a glance

Primary validation papers

Large-scale clinical implementation