Global Accessibility Rating

What this tool is and how to interpret its evidence

The Global Accessibility Rating is a historical single global judgement used to screen for delirium on a general medical ward. It asks the clinician to rate how cognitively accessible the patient appears rather than completing a multidomain symptom scale. The publication abstract does not provide an itemised manual, numerical threshold, exact completion time or contemporary training procedure. It should therefore not be presented as a form that readers can recreate from this site.

Anthony and colleagues evaluated the rating in 97 medical inpatients in 1985, using a psychiatrist's standardised clinical diagnosis as the criterion. Ten patients had delirium. The global rating was reported as 90% sensitive and 95% specific and remained stable across two days. In the same paper, a hand-held tachistoscope had high sensitivity but poor specificity. The global result is encouraging, but it represents only nine true-positive ratings in one small historical sample and has no identified external validation programme.

The record belongs in the historical timeline and related-measures collection, not the current core count. Its strength was extreme brevity and reliance on bedside clinical observation. Its weaknesses are a single subjective judgement, unclear operational anchors and limited evidence across raters and settings. The page should preserve the 1985 contribution and link to the PubMed record, while stating that modern clinical use requires a reproducible, validated assessment and broader evaluation of acute onset, fluctuation, attention and underlying cause.