K-APDS — Korean Adult Patients Delirium Screening Tool

What this tool is and how to interpret its evidence

K-APDS is a Korean-language nursing observation screen developed for adults admitted to general hospital wards. It contains 12 binary observations grouped into two factors: eight reflecting cognitive disturbance and four reflecting psychomotor retardation. The responsible nurse scores features observed while caring for the patient during a work shift, making it an observational screen rather than a one-time cognitive interview. Scores range from 0 to 12, and the development paper proposed a threshold of two or more for a positive screen. A positive result should prompt fuller clinical assessment; it is not itself a diagnosis.

The study involved 317 adults from general wards in three Korean tertiary hospitals during October and November 2022. Two-factor analysis explained 60.1% of variance, internal consistency was high, and correlation with the Delirium Observation Screening Scale was 0.94. At the proposed threshold, the authors reported sensitivity of 91.1%, specificity of 82.4%, positive predictive value of 52.6% and negative predictive value of 97.8%.

Those figures require cautious presentation. The comparator used for criterion validity was another observational screen, not a blinded independent specialist DSM assessment. Development and evaluation occurred in the same study, inter-rater agreement was not assessed, and several clinically complex groups were excluded. The authors also discuss possible missed hypoactive cases arising from routine referral practice. K-APDS is therefore a genuine emerging delirium screen, but it should remain non-counted until independent reference-standard validation and broader replication are available.