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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.

At a glance

Purpose
Episodic assessment
Population
Paediatric
Setting
Intensive care
Time
rating follows observation over the preceding four hours; the primary study did not establish a separate completion time
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.

Primary validation papers

4 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

  • SOS-PD form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
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Tool and original sources

A source for the tool or its access information is linked below. Check the version and current terms before use, copying or adaptation.

Open the official tool page ↗ Read the full paper ↗ Official information and permissions ↗

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.

    Open PubMed ↗Download article PDF ↓

    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.

    Open PubMed ↗
  • 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.

    Open PubMed ↗
Multiple DTA studies identifiedCore instrument family
Classification

Classification

Episodic assessmentAssessment of delirium in childrenMonitoring for new onset deliriumUse 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 evidenceMultiple 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 evaluations
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
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 4 identified papers
  1. Ista E, Te Beest H, van Rosmalen J, de Hoog M, Tibboel D, van Beusekom B, van Dijk M (2018). 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.

    Reference category: independent clinical reference.

  2. 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 (2018). Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study. Critical care (London, England).

    Reference category: other comparator or secondary accuracy evidence.

  3. Stenkjaer RL, Egerod I, Moszkowicz M, Ista E, Greisen G, Weis J, Pagsberg AK, Herling SF (2024). 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.

    Reference category: independent clinical reference.

  4. Matsuishi Y, Hoshino H, Enomoto Y, Kido T, Matsuzaki A, Shimojo N, Mathis BJ, Gallagher J, Ista E, Inoue Y (2025). Verifying the accuracy of Japanese version of the pediatric delirium assessment scale: SOS-PD and the high accuracy of family assessments of pediatric delirium. PloS one.

    Reference category: independent clinical reference.

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.

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.