SQiD: Single Question in Delirium

2010

SQiD is an informant-based, single-question screen for a recent change in confusion. It is a case-finding prompt rather than a diagnostic assessment.

At a glance

Purpose: Episodic assessment
Population: Adult
Setting: Palliative care, General / acute hospital
Time: <1 min
Items: 1
Score or threshold: Informant 'more confused lately?'

Format: The instrument records 1 scored item or observation. This site classifies it under episodic assessment and informant tools. It is intended for adult use in Palliative care, General / acute hospital. The stated administration time is <1 min. The published result is recorded using Informant 'more confused lately?'.

Strengths: Single informant question that can rapidly surface acute change from a patient's baseline
Limitations: Requires an available informant who knows the patient's baseline; evidence remains small and heterogeneous, and neither a positive nor a negative answer establishes or excludes delirium

Training and instructions

Scottish Delirium Association pathway. Public clinical pathway describing observation, concern and follow-on assessment. This is pathway guidance, not a certification course.

Start here

Tool and original sources

This record describes a method rather than a downloadable bedside form. The main source is linked below.

NIDUS information cards ↗

Original and selected diagnostic-accuracy papers

Original paperSands MB, Dantoc BP, Hartshorn A, Ryan CJ, Lujic S. Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Palliative medicine. 2010;24(6):561-5. doi: 10.1177/0269216310371556. PMID: 20837733.
This is the original published source for SQiD. It reported sensitivity of 80% and specificity of 71% against an independent DSM-IV clinical assessment.
Open PubMed ↗
Selected diagnostic-accuracy studyHendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, et al. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age and ageing. 2016;45(6):832-837. doi: 10.1093/ageing/afw130. PMID: 27503794.
This diagnostic-accuracy study evaluated SQiD in geriatric medical assessment unit of an urban teaching hospital against a DSM-5 clinical assessment. It reported sensitivity of 91.4% and specificity of 61.3% in 141 patients with informant SQiD data within a 500-patient cohort.
Open PubMed ↗
Selected diagnostic-accuracy studyLin HS, Eeles E, Pandy S, Pinsker D, Brasch C, Yerkovich S. Screening in delirium: A pilot study of two screening tools, the Simple Query for Easy Evaluation of Consciousness and Simple Question in Delirium. Australasian journal on ageing. 2015;34(4):259-64. doi: 10.1111/ajag.12216. PMID: 26059554.
This diagnostic-accuracy study evaluated SQiD in general medical wards of a general hospital against a DSM-IV clinical assessment. It reported sensitivity of 77% and specificity of 51% in 100 general medical inpatients and their informants.
Open PubMed ↗

Multiple DTA studies identifiedCore instrument family

Classification

Episodic assessment Informant 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

Headline metric source

Original/source study · 2010; pmid:20837733

Denominator: Reported source unit: 19 (analysis unit not fully reconciled)
Reference standard: Blinded psychiatrist DSM-IV interview

80%

Sensitivity

71%

Specificity

Original study estimate from 19 paired SQiD and psychiatrist assessments among 21 consented admissions; confidence intervals were very wide and later results vary by setting.

Expanded evidence profile

What the broader evidence shows

Interpretation: SQiD is a one-question, informant-based case-finding prompt, not a stand-alone diagnostic test. It can bring an acute change from baseline to clinical attention when a suitable informant is available, but accuracy has varied markedly across small studies and a negative answer does not rule out delirium.

Evidence snapshots

Original palliative-care study (2010): In 19 paired cases, sensitivity was 80% and specificity 71%, with very wide confidence intervals.
General medical wards (2015): Among 100 patients with informant SQiD data, sensitivity was 77% and specificity 51%.
Geriatric medical inpatients (2016): Among 141 patients with usable informant data, sensitivity was 91.4% and specificity 61.3%.
Hospitalised cancer patients (2021): Among 73 paired SQiD and psychiatrist assessments, sensitivity was 44% and specificity 87%.

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

7 selected PubMed-indexed papers, 2010–2025

2010Original validation study
Sands MB, Dantoc BP, Hartshorn A, Ryan CJ, Lujic S. Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Palliat Med. 2010;24(6):561-565. doi: 10.1177/0269216310371556. PMID: 20837733.
The question asking whether the patient had been more confused lately was put to family or friends and compared with blinded psychiatrist assessment in 19 paired cases from 21 consented admissions. Sensitivity was 80%, specificity 71% and negative predictive value 91%, but all estimates had very wide confidence intervals because the sample was tiny.
PubMed · PMID 20837733 ↗
2015Systematic review
De J, Wand AP. Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients. Gerontologist. 2015;55(6):1079-1099. doi: 10.1093/geront/gnv100. PMID: 26543179.
This systematic review included 31 studies describing 21 delirium screening tools in non-critical-care hospital inpatients. It regarded SQiD as promising in oncology but could rely only on the original small study; PubMed links a 2016 erratum to the review.
PubMed · PMID 26543179 ↗
2015Diagnostic-accuracy study
Lin HS, Eeles E, Pandy S, Pinsker D, Brasch C, Yerkovich S. Screening in delirium: A pilot study of two screening tools, the Simple Query for Easy Evaluation of Consciousness and Simple Question in Delirium. Australas J Ageing. 2015;34(4):259-264. doi: 10.1111/ajag.12216. PMID: 26059554.
SQiD was asked of informants for 100 general-medical patients and compared with a geriatric consultant's delirium assessment. Sensitivity was 77%, specificity 51% and negative predictive value 83%, demonstrating appreciable false-positive and false-negative rates.
PubMed · PMID 26059554 ↗
2016Diagnostic-accuracy study
Hendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, et al. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age Ageing. 2016;45(6):832-837. doi: 10.1093/ageing/afw130. PMID: 27503794.
Within a consecutive cohort of 500 geriatric medical inpatients, usable informant SQiD data were available for only 141 patients and were compared with elderly-care physicians' clinical diagnosis. For definite delirium, sensitivity was 91.4% and specificity 61.3%, but the amount of missing informant data is a major real-world limitation.
PubMed · PMID 27503794 ↗
2018Systematic review
Rosgen B, Krewulak K, Demiantschuk D, Ely EW, Davidson JE, Stelfox HT, et al. Validation of Caregiver-Centered Delirium Detection Tools: A Systematic Review. J Am Geriatr Soc. 2018;66(6):1218-1225. doi: 10.1111/jgs.15362. PMID: 29671281.
This review screened 6,056 records, included six articles and identified six caregiver-centred delirium tools, including the caregiver-informed SQiD. Only the original very small SQiD validation was then available, so the review called for larger multicentre studies and evaluation of caregiver outcomes.
PubMed · PMID 29671281 ↗
2021Diagnostic-accuracy study
Sands MB, Sharma S, Carpenter L, Hartshorn A, Lee JT, Lujic S, et al. SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients? BMC Cancer. 2021;21(1):75. doi: 10.1186/s12885-020-07504-x. PMID: 33461523.
In two cancer centres, 73 patients had paired SQiD and psychiatrist assessments, with most participants having advanced cancer. Sensitivity was 44%, specificity 87% and negative predictive value about 74%, showing that a negative SQiD could not safely exclude delirium in this population.
PubMed · PMID 33461523 ↗
2025Clinical implementation study
Trabert J, Smolka V, Caudal M, Saller T, Schuetze S, Koenig M. The Single Question in Delirium as a suitable tool to improve delirium detection in hospitalized older patients. Eur Geriatr Med. 2025;16(6):2203-2212. doi: 10.1007/s41999-025-01314-9. PMID: 41074921.
On one awareness day, 403 patients aged 70 years or older across three German hospitals were assessed with 4AT and SQiD, and combining them increased the possible-delirium rate from 20.3% to 31.3%. Because there was no independent diagnostic reference standard, this is useful implementation evidence rather than a diagnostic-accuracy study.
PubMed · PMID 41074921 ↗

This is a selected evidence overview, not a systematic review. Seven papers were retained to show the original small study, later hospital and cancer validations, caregiver-centred reviews and a recent implementation study; all seven main records were checked in PubMed and Scite on 30 August 2026, and Scite identified the linked 2016 erratum to the 2015 De and Wand review but no retraction or expression of concern for the selected set.

More evidence and citation details

Full name: Single Question in Delirium
Also known as: SQiD
Evidence summary: Systematic reviews and multiple diagnostic-accuracy studies; no robust tool-specific pooled estimate
Diagnostic-accuracy evaluations: 5
Reference standard: Psychiatrist interview
Reliability: ;
Citation: Sands MB, Dantoc BP, Hartshorn A, Ryan CJ, Lujic S Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale Palliative medicine. 2010;24(6):561-5. PMID 20837733

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 5 identified papers

Sands MB, Dantoc BP, Hartshorn A, Ryan CJ, Lujic S (2010). Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Palliative medicine.
Reference category: independent clinical reference.
Lin HS, Eeles E, Pandy S, Pinsker D, Brasch C, Yerkovich S (2015). Screening in delirium: A pilot study of two screening tools, the Simple Query for Easy Evaluation of Consciousness and Simple Question in Delirium. Australasian journal on ageing.
Reference category: independent clinical reference.
Hendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, Cunnington A, Stott DJ (2016). Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age and ageing.
Reference category: independent clinical reference.
Iratxe Sancho-Espinosa, Claudio Calvo-Espinós, Hugo Arasanz Esteban, Alejandra Lacalle Emboroujo, Estefanía Ruiz de Gaona Lana (2018). Valor de una herramienta de cribado de una sola pregunta en el despistaje de delirium por parte de enfermería en pacientes con cáncer en un servicio de oncología. Medicina Paliativa.
Reference category: independent clinical reference.
Sands MB, Sharma S, Carpenter L, Hartshorn A, Lee JT, Lujic S, Congdon ME, Buchanan AM, Agar M, Vardy JL (2021). "SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?" running heading Single Question in Delirium" (Bcan-D-20-01665). BMC cancer.
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.