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SOS-PD: Sophia Observation Withdrawal Symptoms – Paediatric Delirium

2018

A PICU nurse-observation checklist combining paediatric-delirium and iatrogenic-withdrawal monitoring on one form. The delirium component is scored after a four-hour observation period and should not be confused with the overlapping withdrawal component.

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Classification

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Tool and original sources

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Original and selected diagnostic-accuracy papers

  • Original paperIsta E, van Beusekom B, van Rosmalen J, Kneyber MCJ, Lemson J, Brouwers A, et al. Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study. Critical care (London, England). 2018;22(1):309. doi: 10.1186/s13054-018-2238-z. PMID: 30458826.

    This paper reports the original validation of SOS-PD. It reported sensitivity of 92.3% and specificity of 96.5% against an independent DSM-IV clinical assessment.

    Article PDF: CC BY. This licence applies to the article PDF and does not grant rights to reproduce the tool.

  • Selected diagnostic-accuracy studyIsta E, Te Beest H, van Rosmalen J, de Hoog M, Tibboel D, van Beusekom B, et al. Sophia Observation withdrawal Symptoms-Paediatric Delirium scale: A tool for early screening of delirium in the PICU. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses. 2018;31(5):266-273. doi: 10.1016/j.aucc.2017.07.006. PMID: 28843537.

    This diagnostic-accuracy study evaluated SOS-PD in paediatric ICU against an independent DSM-IV clinical assessment. It reported sensitivity of 96.8% and specificity of 92% in 63 paired diagnoses/assessments in 14 critically ill children.

  • Selected diagnostic-accuracy studyStenkjaer RL, Egerod I, Moszkowicz M, Ista E, Greisen G, Weis J, et al. Prospective validation of Sophia observation withdrawal symptoms: A paediatric delirium scale in critically ill children in Denmark. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses. 2024;37(3):400-406. doi: 10.1016/j.aucc.2023.04.001. PMID: 37164889.

    This diagnostic-accuracy study evaluated SOS-PD in danish paediatric ICU against an independent DSM-5 clinical assessment. It reported sensitivity of 83.3% and specificity of 96.4% in 141 critically ill children; 30 delirium cases.

Multiple DTA studies identifiedCore instrument family

At a glance

Purpose
Episodic assessment
Population
Paediatric
Setting
Intensive care
Time
brief end-of-shift rating, commonly reported as 2-5 min; formal timing was not reported in the primary study
Items
22
Score or threshold
Paediatric-delirium component 0-17; positive at 4 or more

Format: The combined nurse checklist contains 22 unique lines shared across paediatric-delirium and iatrogenic-withdrawal assessment. The delirium component uses 17 symptom ratings over the preceding four hours and a parent-perspective trigger; hallucination or parent non-recognition reaches the positive threshold.

Evidence

Evidence maturityMultiple DTA studies identified

Reported sensitivity and specificity

Headline metric source

Original/source study · 2018 — pmid:30458826

Denominator
Reported source unit: 485 (analysis unit not fully reconciled)
Reference standard
Child psychiatrist DSM-IV clinical examination with collateral and chart review
92.3%
Sensitivity
96.5%
Specificity

Multicentre validation in 485 critically ill children.

More evidence and citation details
Full name
Sophia Observation Withdrawal Symptoms – Paediatric Delirium
Also known as
SOS-PD, Sophia Observation withdrawal Symptoms Paediatric Delirium
Evidence summary
multi
Diagnostic-accuracy studies
4
Reference standard
Blinded child-psychiatrist DSM-IV assessment
Citation
Ista E, van Beusekom B, van Rosmalen J, Kneyber MCJ, Lemson J, Brouwers A, Dieleman GC, Dierckx B, de Hoog M, Tibboel D, van Dijk M Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study Critical care (London, England). 2018;22(1):309. PMID 30458826
Copyright and reuse
Version
English SOS-PD final version hosted by the developer resource
Information checked
2026-07-19

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

Sources checked 2026-07-29. How profiles are prepared.