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mRASS: Modified Richmond Agitation-Sedation Scale

2012

Single-item modified RASS to capture altered arousal/consciousness; useful as a daily screen, especially when tracking change.

At a glance

Purpose
Domain-specific or adjunctive measure
Population
Adult
Setting
General / acute hospital
Time
<30 sec
Items
1

Format: The instrument records 1 scored item or observation. This site classifies it under domain-specific or adjunctive measure, ultra-brief bedside tools and monitoring for new onset delirium. It is intended for adult use in General / acute hospital. The stated administration time is <30 sec.

Primary validation papers

2 identified diagnostic-accuracy papers

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

None identified in the scoped review.

None identified in the selected profile sources and the Penfold general-hospital review. This is not a completed search of all settings or later papers.

Training and instructions

Public training resources have not yet been confirmed in this review. Check the linked developer or original source for instructions.

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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.

Search Google Images ↗ NIDUS information cards ↗

Original and selected diagnostic-accuracy papers

  • Original paperChester JG, Beth Harrington M, Rudolph JL, VA Delirium Working Group. Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. Journal of hospital medicine. 2012;7(5):450-3. doi: 10.1002/jhm.1003. PMID: 22173963.

    This is the original published source for mRASS. It reported sensitivity of 64% (single); 74% (serial) and specificity of 93% (single); 92% (serial) against the study reference standard.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyGrossmann FF, Hasemann W, Kressig RW, Bingisser R, Nickel CH. Performance of the modified Richmond Agitation Sedation Scale in identifying delirium in older ED patients. The American journal of emergency medicine. 2017;35(9):1324-1326. doi: 10.1016/j.ajem.2017.05.025. PMID: 28559128.

    This diagnostic-accuracy study evaluated mRASS in emergency department against DSM delirium diagnosis. It reported sensitivity of 70% and specificity of 93% in 285 consecutive emergency patients aged 65 years or older.

    Open PubMed ↗
Multiple DTA studies identifiedCore instrument family
Classification

Classification

Domain-specific or adjunctive measureUltra-brief bedside toolsMonitoring for new onset delirium

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

Evidence

Diagnostic-accuracy evidenceMultiple DTA studies identified

Reported sensitivity and specificity

Headline metric source

Original/source study · 2012; pmid:22173963

Denominator
Not yet reconciled
Reference standard
Not recorded
64% (single); 74% (serial)
Sensitivity
93% (single); 92% (serial)
Specificity

Original validation, n=95.

More evidence and citation details
Full name
Modified Richmond Agitation-Sedation Scale
Also known as
mRASS, modified RASS
Evidence summary
multi
Diagnostic-accuracy evaluations
2
Citation
Chester JG, Beth Harrington M, Rudolph JL, VA Delirium Working Group Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening Journal of hospital medicine. 2012;7(5):450-3. PMID 22173963
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 2 identified papers
  1. Chester JG, Beth Harrington M, Rudolph JL, VA Delirium Working Group (2012). Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. Journal of hospital medicine.

    Reference category: independent clinical reference.

  2. Grossmann FF, Hasemann W, Kressig RW, Bingisser R, Nickel CH (2017). Performance of the modified Richmond Agitation Sedation Scale in identifying delirium  in older ED patients. The American journal of emergency medicine.

    Reference category: independent clinical reference.

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.