DelApp-ICU

What this tool is and how to interpret its evidence

DelApp-ICU is the intensive-care adaptation of the DelApp smartphone assessment. It presents a graded task designed to quantify arousal and sustained attention, two domains frequently impaired in delirium and difficult to assess consistently in critically ill patients. In the first feasibility study, administration took roughly three to eight minutes.

Tang and colleagues compared performance across ICU patients with delirium, patients without delirium and healthy comparison participants. On first assessment, a score of 6 or less produced reported sensitivity of 100% and specificity of 96%. These striking estimates arose from a small case-control-style feasibility sample and are vulnerable to spectrum and selection effects. They should not be presented as externally validated bedside accuracy or assumed to apply to all ventilated, sedated, neurologically impaired or visually impaired patients.

DelApp-ICU is valuable as an objective measurement of attention and arousal and may support monitoring, but it does not by itself demonstrate acute onset, fluctuation or the full delirium syndrome. The record should be a provisional version page within the DelApp family and excluded from the independent-family count. It can describe the digital format, approximate duration, initial threshold and evidence limitations without recreating the task. Clinical use requires access to the authorised application, appropriate patient selection and integration with a full delirium assessment.