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DDT-Pro: Delirium Diagnostic Tool-Provisional

2020

A three-domain, 0-9 clinician assessment for provisional identification of delirium and subsyndromal delirium. Lower totals indicate greater impairment; it has now been evaluated in general hospital, rehabilitation, nursing-facility and ICU cohorts.

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
General / acute hospital
Time
brief clinician assessment; exact completion time is not consistently reported
Items
3
Score or threshold
Lower scores indicate greater impairment; published studies evaluate thresholds of 6 or less and 7 or less

Format: Three clinician ratings represent cognition, higher-order thinking and circadian disturbance. The total ranges from 0 to 9, with lower values indicating greater abnormality;

Primary validation papers

7 identified diagnostic-accuracy papers

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

Large-scale clinical implementation

None identified in the scoped review.

None identified in the selected profile sources and the Penfold general-hospital review. This is not a completed search of all settings or later papers.

Training and instructions

Public training resources have not yet been confirmed in this review. Check the linked developer or original source for instructions.

Start here

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 and selected diagnostic-accuracy papers

  • Original paperFranco JG, Trzepacz PT, Sepúlveda E, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, et al. Delirium diagnostic tool-provisional (DDT-Pro) scores in delirium, subsyndromal delirium and no delirium. General hospital psychiatry. 2020;67:107-114. doi: 10.1016/j.genhosppsych.2020.10.003. PMID: 33091783.

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

    Open PubMed ↗
  • Selected diagnostic-accuracy studyFranco JG, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, Giraldo AM, Serna PA, et al. Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) With Medical Inpatients and Comparison With the Confusion Assessment Method Algorithm. The Journal of neuropsychiatry and clinical neurosciences. 2020;32(3):213-226. doi: 10.1176/appi.neuropsych.18110255. PMID: 31662094.

    This diagnostic-accuracy study evaluated DDT-Pro in general medical wards in Colombia against independent DSM-based expert clinical diagnosis. It reported sensitivity of 90% and specificity of 85.3% in 200 general medical inpatients.

    Open PubMed ↗
  • Selected diagnostic-accuracy studySepúlveda E, Bermúdez E, González D, Cotino P, Viñuelas E, Palma J, et al. Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 'A's test (4AT). General hospital psychiatry. 2021;70:116-123. doi: 10.1016/j.genhosppsych.2021.03.010. PMID: 33813146.

    This diagnostic-accuracy study evaluated DDT-Pro in skilled nursing facility against a DSM-5 clinical assessment. It reported sensitivity of 77.2% and specificity of 84% in 262 skilled-nursing-facility residents; 141 had dementia and 79 delirium.

    Open PubMed ↗
Multiple DTA studies identifiedCore instrument family
Classification

Classification

Episodic assessment

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceMultiple DTA studies identified

Reported sensitivity and specificity

;
Sensitivity
;
Specificity

Three-item scale (0–9); cut-off ≤6. Strong accuracy (AUC ~88–96%) in later validation (Botero Urrea 2024, PMID 39126891).

More evidence and citation details
Full name
Delirium Diagnostic Tool-Provisional
Also known as
DDT-Pro, Delirium Diagnostic Tool Provisional
Evidence summary
multi-study
Diagnostic-accuracy evaluations
8
Reference standard
Clinical neuropsychologist DSM-IV-TR delirium diagnosis supported by DRS-R-98
Citation
Franco JG, Trzepacz PT, Sepúlveda E, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, Restrepo C, Giraldo AM, Serna PA, Zuluaga A, López C Delirium diagnostic tool-provisional (DDT-Pro) scores in delirium, subsyndromal delirium and no delirium General hospital psychiatry. 2020;67:107-114. PMID 33091783
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 7 identified papers
  1. Kean J, Trzepacz PT, Murray LL, Abell M, Trexler L (2010). Initial validation of a brief provisional diagnostic scale for delirium. Brain injury.

    Reference category: independent clinical reference.

  2. Franco JG, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, Giraldo AM, Serna PA, López C, Zuluaga A, Sepúlveda E, Kean J, Trzepacz PT (2020). Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) With Medical Inpatients and Comparison With the Confusion Assessment Method Algorithm. The Journal of neuropsychiatry and clinical neurosciences.

    Reference category: independent clinical reference.

  3. Sepúlveda E, Bermúdez E, González D, Cotino P, Viñuelas E, Palma J, Ciutat M, Grau I, Vilella E, Trzepacz PT, Franco JG (2021). Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 'A's test (4AT). General hospital psychiatry.

    Reference category: independent clinical reference.

  4. Botero Urrea M, González MC, Villa García MM, Alviz Núñez M, Velásquez-Tirado JD, Ocampo MV, Trzepacz PT, Franco JG (2024). Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium. Journal of psychosomatic research.

    Reference category: independent clinical reference.

  5. Probert J, Valencia C, Bernal C, Muñoz N, Kishi Y, Yamaguchi T, Sepúlveda E, Enriquez R, Pérez P, Pintor L, Franco JG, Trzepacz PT (2025). Validation of the Delirium Diagnostic Tool-Provisional in intensive care units. Medicine.

    Reference category: independent clinical reference.

  6. Sinthunyathum P, Vanitcharoenkul E, Unnanuntana A, Trzepacz PT, Chotiyarnwong P, Franco JG (2026). Validity and Reliability of the Thai Version of the Delirium Diagnostic Tool-Provisional (DDT-Pro-TH) in Perioperative Patients With Fragility Hip Fractures. Medical science monitor : international medical journal of experimental and clinical research.

    Reference category: independent clinical reference.

  7. Xu S, Chen J, Dai H, Zhang Q, Franco JG (2026). Validation of the Chinese version of the delirium diagnostic tool-provisional (DDT-Pro) among the older adults in the community. Geriatric nursing (New York, N.Y.).

    Reference category: independent clinical reference.

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.