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Sour Seven: Sour Seven Questionnaire

2016

Seven-item questionnaire suitable for completion by informal or untrained caregivers to screen for delirium in hospitalised seniors.

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
General / acute hospital
Time
variable
Items
7
Score or threshold
Derivation study: ≥4 for screening and ≥9 as a more specific threshold. A positive score requires clinical assessment.

Format: The instrument records 7 scored items or observations. This site classifies it under episodic assessment and informant tools. It is intended for adult use in General / acute hospital. The stated administration time is variable. The published result is recorded using Derivation study: ≥4 for screening and ≥9 as a more specific threshold. A positive score requires clinical assessment..

  • Strengths: Usable by untrained/informal caregivers
  • Limitations: Small validation sample

Primary validation papers

3 identified diagnostic-accuracy papers

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

Large-scale clinical implementation

Not yet reviewed.

A focused implementation review has not yet been completed for this profile.

Training and instructions

  • Sour Seven form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
Start here

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.

View the hosted tool ↗ Search Google Images ↗ NIDUS information cards ↗

Original and selected diagnostic-accuracy papers

  • Original paperShulman RW, Kalra S, Jiang JZ. Validation of the Sour Seven Questionnaire for screening delirium in hospitalized seniors by informal caregivers and untrained nurses. BMC geriatrics. 2016;16:44. doi: 10.1186/s12877-016-0217-2. PMID: 26879927.

    This paper reports the original validation of Sour Seven. It is the main source for the method, its intended use and the evidence available at publication.

    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 studyFiest KM, Krewulak KD, Ely EW, Davidson JE, Ismail Z, Sept BG, et al. Partnering With Family Members to Detect Delirium in Critically Ill Patients. Critical care medicine. 2020;48(7):954-961. doi: 10.1097/CCM.0000000000004367. PMID: 32332281.

    This diagnostic-accuracy study evaluated Sour Seven in large tertiary-care academic adult ICU against an independent DSM-5 clinical assessment. It reported sensitivity of 72.9% and specificity of 68.8% in 147 ICU patient-family dyads.

    Open PubMed ↗
Multiple DTA studies identifiedCore instrument family
Classification

Classification

Episodic assessmentInformant tools

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

89.5%
Sensitivity
90%
Specificity

Score ≥4; n=39 with psychiatrist reference.

More evidence and citation details
Full name
Sour Seven Questionnaire
Also known as
Sour Seven
Evidence summary
multi
Diagnostic-accuracy evaluations
3
Reference standard
Geriatric psychiatrist
Reliability
;
Citation
Shulman RW, Kalra S, Jiang JZ Validation of the Sour Seven Questionnaire for screening delirium in hospitalized seniors by informal caregivers and untrained nurses BMC geriatrics. 2016;16:44. PMID 26879927
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 3 identified papers
  1. Shulman RW, Kalra S, Jiang JZ (2016). Validation of the Sour Seven Questionnaire for screening delirium in hospitalized seniors by informal caregivers and untrained nurses. BMC geriatrics.

    Reference category: other comparator or secondary accuracy evidence.

  2. Fiest KM, Krewulak KD, Ely EW, Davidson JE, Ismail Z, Sept BG, Stelfox HT (2020). Partnering With Family Members to Detect Delirium in Critically Ill Patients. Critical care medicine.

    Reference category: other comparator or secondary accuracy evidence.

  3. Zhu S, Liu S, Li L, Xing H, Xia M, Dong G (2024). Translation, cultural debugging, and validation of the Chinese version of the Sour Seven Questionnaire: a cross-sectional study. Frontiers in medicine.

    Reference category: other comparator or secondary accuracy evidence.

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.