S-PTD: Stanford Proxy Test for Delirium

2018

A nurse proxy screen scored from observations across a shift, without direct cognitive testing. The original English form has 12 items; the Spanish adaptation describes 13 items.

At a glance

Purpose: Episodic assessment
Population: Adult
Setting: General / acute hospital, Intensive care
Time: approximately 1 min at the end of a shift
Items: 12
Score or threshold: Total 0-20; positive at 3 or more

Format: A nurse-completed proxy assessment scored at the end of a shift. The original total ranges from 0 to 20 and uses a threshold of 3 or more; use version-specific wording and anchors.

Limitations: Only three direct PubMed validations were identified; all include the developer group and hospital populations. Versions have 12 or 13 items. A negative result does not rule out delirium, and a positive result is not a diagnosis

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.

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Original and selected diagnostic-accuracy papers

Original paperAlosaimi FD, Alghamdi A, Alsuhaibani R, Alhammad G, Albatili A, Albatly L, et al. Validation of the Stanford Proxy Test for Delirium (S-PTD) among critical and noncritical patients. Journal of psychosomatic research. 2018;114:8-14. doi: 10.1016/j.jpsychores.2018.08.009. PMID: 30314583.
This original 12-item English S-PTD study enrolled 288 adults in an intensive care unit and three wards; trained nurses and a consultation-liaison psychiatrist assessed patients independently and blinded on the same day. At 3 or more, sensitivity was 82.7%, specificity 95.3% and AUC 0.946 against DSM-5; study nurses received a one-day workshop.
Open PubMed ↗
Selected diagnostic-accuracy studyMaldonado JR, Sher YI, Benitez-Lopez MA, Savant V, Garcia R, Ament A, et al. A Study of the Psychometric Properties of the "Stanford Proxy Test for Delirium" (S-PTD): A New Screening Tool for the Detection of Delirium. Psychosomatics. 2020;61(2):116-126. doi: 10.1016/j.psym.2019.11.009. PMID: 31926650.
In 199 analysed non-intensive-care inpatients contributing 405 hospital days, primary nurses completed S-PTD while blinded psychiatrists performed neuropsychiatric assessment. Sensitivity was 80.72% and specificity 90.37%; repeated hospital-day analyses and 79 exclusions for incomplete data limit simple patient-level interpretation.
Open PubMed ↗
Selected diagnostic-accuracy studyInfante S, Behn A, González M, Pintor L, Franco E, Araya P, et al. Reliability and Validity of the Spanish Adaptation of the Stanford Proxy Test for Delirium in Two Clinical Spanish-Speaking Communities. Journal of the Academy of Consultation-Liaison Psychiatry. 2024;65(2):136-147. doi: 10.1016/j.jaclp.2023.09.004. PMID: 37806639.
This Spanish adaptation enrolled 123 adults across medical-surgical and intensive-care services in Barcelona and Santiago, with blinded DSM-5 assessment within one hour. At 3 or more, sensitivity was 94%, specificity 97% and AUC 0.95; the paper describes 13 items, unlike the 12-item original English form.
Open PubMed ↗

Pooled diagnostic-accuracy evidenceCore instrument family

Classification

Episodic assessment Monitoring for new onset delirium Use in intensive care units

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

Evidence

Diagnostic-accuracy evidencePooled diagnostic-accuracy evidence

Reported sensitivity and specificity

Headline metric source

Original/source study · 2018; pmid:30314583

Denominator: Reported source unit: 288 (analysis unit not fully reconciled)
Reference standard: Consultation-liaison psychiatrist clinical neuropsychiatric evaluation using DSM-5 delirium criteria

82.7%

Sensitivity

95.3%

Specificity

Original 2018 study in 288 hospitalised adults: trained nurses and a blinded consultation-liaison psychiatrist assessed patients independently on the same day; at 3 or more sensitivity was 82.7% and specificity 95.3%. Later studies and pooled estimates are shown below.

Expanded evidence profile

What the broader evidence shows

Interpretation: S-PTD is a nurse-completed proxy screen based on observations accumulated across a shift rather than direct cognitive testing. Three PubMed-indexed validation studies reported sensitivity of about 81% to 94% and specificity of about 90% to 97%, but all include the developer group and the evidence remains limited to hospital settings. A result should prompt clinical assessment, not be treated as a diagnosis or rule-out.

Evidence snapshots

Original mixed-setting validation (2018): Among 288 adults, sensitivity was 82.7% and specificity 95.3% at a threshold of 3 or more.
Non-intensive-care validation (2020): Among 199 analysed inpatients contributing 405 hospital days, sensitivity was 80.72% and specificity 90.37%.
Spanish adaptation (2024): Among 123 adults, sensitivity was 94% and specificity 97% at a threshold of 3 or more.
Intensive-care network meta-analysis (2026): Pooled S-PTD sensitivity was 92.2% and specificity 97.7%, but the node contained only three articles and included mixed-setting and conference evidence.

These results come from different populations and workflows and should not be averaged or treated as interchangeable.

6 selected PubMed-indexed papers, 2018–2026

2018Original validation study
Alosaimi FD, Alghamdi A, Alsuhaibani R, Alhammad G, Albatili A, Albatly L, et al. Validation of the Stanford Proxy Test for Delirium (S-PTD) among critical and noncritical patients. J Psychosom Res. 2018;114:8-14. doi: 10.1016/j.jpsychores.2018.08.009. PMID: 30314583.
This original 12-item English S-PTD study enrolled 288 adults in an intensive care unit and three wards; trained nurses and a consultation-liaison psychiatrist assessed patients independently and blinded on the same day. At 3 or more, sensitivity was 82.7%, specificity 95.3% and AUC 0.946 against DSM-5; study nurses received a one-day workshop.
PubMed · PMID 30314583 ↗
2020Diagnostic-accuracy study
Maldonado JR, Sher YI, Benitez-Lopez MA, Savant V, Garcia R, Ament A, et al. A Study of the Psychometric Properties of the Stanford Proxy Test for Delirium (S-PTD): A New Screening Tool for the Detection of Delirium. Psychosomatics. 2020;61(2):116-126. doi: 10.1016/j.psym.2019.11.009. PMID: 31926650.
In 199 analysed non-intensive-care inpatients contributing 405 hospital days, primary nurses completed S-PTD while blinded psychiatrists performed neuropsychiatric assessment. Sensitivity was 80.72% and specificity 90.37%; repeated hospital-day analyses and 79 exclusions for incomplete data limit simple patient-level interpretation.
PubMed · PMID 31926650 ↗
2020Systematic review and meta-analysis
Ho MH, Montgomery A, Traynor V, Chang CC, Kuo KN, Chang HCR, et al. Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta-Analysis. Worldviews Evid Based Nurs. 2020;17(4):301-310. doi: 10.1111/wvn.12462. PMID: 32786067.
This intensive-care diagnostic review included 29 studies, but only one used S-PTD: the 2018 Alosaimi study. Because there was only one S-PTD dataset, the reviewers extracted its sensitivity and specificity but did not include S-PTD in a pooled summary ROC analysis.
PubMed · PMID 32786067 ↗
2024Diagnostic-accuracy study
Infante S, Behn A, González M, Pintor L, Franco E, Araya P, et al. Reliability and Validity of the Spanish Adaptation of the Stanford Proxy Test for Delirium in Two Clinical Spanish-Speaking Communities. J Acad Consult Liaison Psychiatry. 2024;65(2):136-147. doi: 10.1016/j.jaclp.2023.09.004. PMID: 37806639.
This Spanish adaptation enrolled 123 adults across medical-surgical and intensive-care services in Barcelona and Santiago, with blinded DSM-5 assessment within one hour. At 3 or more, sensitivity was 94%, specificity 97% and AUC 0.95; the paper describes 13 items, unlike the 12-item original English form.
PubMed · PMID 37806639 ↗
2025Systematic review
Tang C, Zhong J, Wang X, Zhu F, Wang B, Zhang Y, et al. Evaluating the Chinese versions of delirium assessment scales: a diagnostic systematic review. BMC Psychiatry. 2025;25:431. doi: 10.1186/s12888-025-06745-z. PMID: 40296051.
This review of 13 Chinese-adapted delirium tools included a 458-patient postoperative S-PTD validation using DSM-5. That S-PTD study reported sensitivity 67.8% and specificity 93.5% at 3 or more; the review's pooled 93% and 94% figures combined seven different tools and are not S-PTD estimates.
PubMed · PMID 40296051 ↗
2026Systematic review and meta-analysis
Li N, Zhou Z, Yao T, Xu X. Diagnostic Accuracy of Screening Tools for Delirium in Adults Receiving Care in Intensive Care Units: A Systematic Review and Network Meta-Analysis. Nurs Health Sci. 2026;28(2):e70344. doi: 10.1111/nhs.70344. PMID: 42077053.
This network meta-analysis included 50 intensive-care studies and reported pooled S-PTD sensitivity 92.2% and specificity 97.7%. The S-PTD node contained only three articles, including mixed-setting evidence and a conference abstract, and the authors called for validation in mechanically ventilated adults.
PubMed · PMID 42077053 ↗

This is a selected evidence overview, not a systematic review. Six PubMed-indexed papers were retained: three direct validation studies and three systematic reviews that materially evaluate S-PTD. All six records were checked in PubMed and Scite on 30 August 2026; no selected record surfaced under Scite retraction, concern, correction or erratum filters. A separate PubMed letter-and-response exchange concerns the 2020 paper's description of Nu-DESC, not a correction to the reported S-PTD results.

More evidence and citation details

Full name: Stanford Proxy Test for Delirium
Also known as: S-PTD
Evidence summary: Systematic reviews and multiple diagnostic-accuracy studies
Diagnostic-accuracy evaluations: 3
Reference standard: Expert neuropsychiatric DSM-5 assessment
Citation: Alosaimi FD, et al. A novel approach to the detection of delirium in hospitalized patients: the Stanford Proxy Test for Delirium (S-PTD) Journal of Psychosomatic Research. 2018;114:8-14. PMID 30314583

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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 3 identified papers

Alosaimi FD, Alghamdi A, Alsuhaibani R, Alhammad G, Albatili A, Albatly L, Althomali B, Aljamaan F, Maldonado JR (2018). Validation of the Stanford Proxy Test for Delirium (S-PTD) among critical and noncritical patients. Journal of psychosomatic research.
Reference category: independent clinical reference.
Maldonado JR, Sher YI, Benitez-Lopez MA, Savant V, Garcia R, Ament A, De Guzman E (2020). A Study of the Psychometric Properties of the "Stanford Proxy Test for Delirium" (S-PTD): A New Screening Tool for the Detection of Delirium. Psychosomatics.
Reference category: independent clinical reference.
Infante S, Behn A, González M, Pintor L, Franco E, Araya P, Maldonado JR (2024). Reliability and Validity of the Spanish Adaptation of the Stanford Proxy Test for Delirium in Two Clinical Spanish-Speaking Communities. Journal of the Academy of Consultation-Liaison Psychiatry.
Reference category: independent clinical reference.

Information checked: 2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Base clinical review: 2026-08-30. Instrument description source check: 2026-09-05. Scope and limitations.