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DI: Delirium Index

1998

A seven-item measure of delirium severity scored from interaction with the patient, including cognitive assessment. It does not require an informant or record review.

At a glance

Purpose
Measurement of delirium severity
Population
Adult
Setting
General / acute hospital
Time
variable
Items
7
Score or threshold
Severity total 0–21. A threshold of ≥7 was evaluated in a later 2010 diagnostic-accuracy study.

Format: The seven items are rated from 0 to 3, giving a total of 0 to 21. The developer’s 2021 instructions specify use with the MMSE or a similar cognitive assessment. Direct observation here includes elicited responses during assessment, not passive observation alone.

Primary validation papers

1 identified diagnostic-accuracy paper

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

  • DI form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
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Tool and original sources

A source for the tool or its access information is linked below. Check the version and current terms before use, copying or adaptation.

Open the official tool page ↗ NIDUS information cards ↗

Original and selected diagnostic-accuracy papers

  • Original paperMcCusker J, Cole M, Bellavance F, Primeau F. Reliability and validity of a new measure of severity of delirium. International psychogeriatrics. 1998;10(4):421-33. doi: 10.1017/s1041610298005493. PMID: 9924835.

    This paper reports the original validation of DI. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyKazmierski J, Kowman M, Banach M, Fendler W, Okonski P, Banys A, et al. The use of DSM-IV and ICD-10 criteria and diagnostic scales for delirium among cardiac surgery patients: results from the IPDACS study. The Journal of neuropsychiatry and clinical neurosciences. 2010;22(4):426-32. doi: 10.1176/jnp.2010.22.4.426. PMID: 21037128.

    This diagnostic-accuracy study evaluated DI in cardiac-surgery inpatient cohort against a DSM-IV clinical assessment. It reported sensitivity of 94.6% and specificity of 94.9% in 563 cardiac-surgery patients.

    Open PubMed ↗
One DTA study identifiedCore instrument family
Classification

Classification

Measurement of delirium severity

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

Evidence

Diagnostic-accuracy evidenceOne DTA study identified

Reported sensitivity and specificity

Headline metric source

Later validation or evaluation · 2010; pmid:21037128

Denominator
Reported source unit: 563 (analysis unit not fully reconciled)
Reference standard
Same-rater psychiatrist DSM-IV clinical delirium diagnosis; ICD-10 was also applied in the study
94.6%
Sensitivity
94.9%
Specificity

Earliest DTA evaluation identified in the current audit; see the linked source and methodological caveats.

More evidence and citation details
Full name
Delirium Index
Also known as
DI
Evidence summary
single
Diagnostic-accuracy evaluations
1
Reference standard
Same-rater psychiatrist DSM-IV clinical delirium diagnosis; ICD-10 was also applied in the study
Citation
McCusker J, Cole M, Bellavance F, Primeau F Reliability and validity of a new measure of severity of delirium International psychogeriatrics. 1998;10(4):421-33. PMID 9924835
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 1 identified paper
  1. Kazmierski J, Kowman M, Banach M, Fendler W, Okonski P, Banys A, Jaszewski R, Rysz J, Sobow T, Kloszewska I (2010). The use of DSM-IV and ICD-10 criteria and diagnostic scales for delirium among cardiac surgery patients: results from the IPDACS study. The Journal of neuropsychiatry and clinical neurosciences.

    Reference category: other comparator or secondary accuracy evidence.

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.