Revised PAED — Revised three-level Pediatric Anesthesia Emergence Delirium Scale

What this tool is and how to interpret its evidence

Revised PAED is a post-hoc modification of the five-item Pediatric Anesthesia Emergence Delirium Scale. Rather than create new symptom domains, it condenses each original five-level behavioural rating into a three-level response. The aim was to replace relatively subjective gradations with simpler anchors that might be easier to apply. The paper reports a threshold of 8 for the three-level version. Observation is brief, but an exact completion time was not reported; users need familiarity with PAED and the study-specific condensed anchors.

Blankespoor and colleagues analysed routine data from 144 non-electively admitted patients aged 1-18 years in one eight-bed PICU. In that post-hoc dataset, the three-level version had internal consistency of 0.86, inter-rater agreement of 0.90, sensitivity of 100%, specificity of 96.7% and an area under the curve of 0.98. These unusually favourable figures were generated while deriving the revision, not confirmed in a prospective external cohort. The authors explicitly called for further research.

The record should remain linked to PAED but sit in an emerging paediatric context collection. PAED originated in post-anaesthetic emergence, while this study explored a broader PICU application; neither fact makes Revised PAED interchangeable with CAPD, pCAM-ICU or specialist assessment. The page can describe the five-item, three-level architecture and evidence design, but should not reproduce anchors. It should be excluded from the independent-family count until prospective validation establishes its role.