Assessment Method: a systematic review of current usage. J Am

The occurrence of delirium in hospitalized older adults ranges from 14 % to> 60%, depending on the population (1). It is associated with increased health care costs and risk for death (1), yet is often missed by clinicians. In their systematic review, Wong and col-leagues examined the test characteristics of 11 bedside delirium screening instruments, calculating pooled LRs and noting the time to perform the test, number of study replications, and per-formance by type of user. The CAM is the best-studied instrument, with a pooled +LR of 9.6 and –LR of 0.16. It has the advantage of being brief (about 5 min) and has been validated by both physicians and nurses in several settings. However, it requires training and was designed to be scored based on observations made during formal cognitive assessment (Mini-Mental State Examination and Digit Span test) (2). Other brief instruments show promise but so far hav