FMSE: Fluctuating Mental Status Evaluation
2023A five-domain neurocritical-care screen that rates fluctuation from an established post-injury cognitive baseline. It is designed to reduce confounding from fixed focal deficits such as aphasia.
Classification
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Tool and original sources
No direct copy is linked here. The original paper and a Google Images search are available below. Image results may be unofficial; check the version and source before use.
Original and selected diagnostic-accuracy papers
- Original paperReznik ME, Margolis SA, Moody S, Drake J, Tremont G, Furie KL, et al. A Pilot Study of the Fluctuating Mental Status Evaluation: A Novel Delirium Screening Tool for Neurocritical Care Patients. Neurocritical care. 2023;38(2):388-394. doi: 10.1007/s12028-022-01612-1. PMID: 36241773.
This is the original published source for FMSE. It reported sensitivity of 86% and specificity of 73% against an independent DSM-5 clinical assessment.
- Selected diagnostic-accuracy studyReznik ME, Margolis SA, Andrews N, Basso C, Mintz N, Varga S, et al. Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke. Critical care medicine. 2024;52(12):1918-1927. doi: 10.1097/CCM.0000000000006437. PMID: 39365697.
This diagnostic-accuracy study evaluated FMSE in academic neurocritical-care unit against an independent DSM-5 clinical assessment. It reported sensitivity of 86% and specificity of 74% in 139 neurocritically ill stroke patients; 717 paired non-comatose patient-days.
At a glance
- Purpose
- Episodic assessment
- Population
- Adult
- Setting
- Intensive care
- Time
- approximately 1 min after relevant observations are available
- Items
- 5
- Score or threshold
- 1 or more indicates possible delirium; 2 or more indicates probable delirium in published neurocritical-care studies
Format: Five binary domain ratings summarise changes in consciousness, orientation, activity, thought content and attention over a defined observation period. The 0-5 total depends on establishing an appropriate neurological baseline;
Evidence
Reported sensitivity and specificity
Original/source study · 2023 — pmid:36241773
- Denominator
- Reported source unit: 40 (analysis unit not fully reconciled)
- Reference standard
- Expert DSM-5 delirium ratings
Earliest DTA evaluation identified in the current audit; see the linked source and methodological caveats.
More evidence and citation details
- Full name
- Fluctuating Mental Status Evaluation
- Also known as
- FMSE
- Evidence summary
- external-validation
- Diagnostic-accuracy studies
- 2
- Reference standard
- Expert DSM-5 delirium ratings
- Citation
- Reznik ME, Margolis SA, Moody S, Drake J, Tremont G, Furie KL, Mayer SA, Ely EW, Jones RN A Pilot Study of the Fluctuating Mental Status Evaluation: A Novel Delirium Screening Tool for Neurocritical Care Patients Neurocritical care. 2023;38(2):388-394. PMID 36241773
Copyright and reuse
- Information checked
- 2026-07-19
Instrument-specific terms apply. See the access and copyright policy or send a correction.
Sources checked 2026-07-29. How profiles are prepared.