New Diagnostic Assessment Accurately IDs Delirium in 3 Minutes

(HealthDay News) — 3D-Confusion Assessment Method (CAM), a three-minute diagnostic assessment, has high sensitivity and specificity for identifying delirium, according to a study published in Annals of Internal Medicine.

Edward R. Marcantonio, MD, from the Beth Deaconess Medical Center in Boston, and colleagues developed and validated the 3D-CAM among 201 inpatients aged 75 years and older. The 20 items that best operationalized the four CAM diagnostic features were identified to create the 3D-CAM. Assessments were administered by trained research assistants for prospective validation. Patient and family interviews and medical records were independently assessed by clinicians. The 3D-CAM delirium diagnosis was compared with the reference standard.

The researchers found that delirium was identified in 21% of the patients based on expert panel assessment, 88% of whom had hypoactive or normal psychomotor features. The 3D-CAM median administration time was three minutes, and sensitivity and specificity were 95 and 94%, respectively. 3D-CAM performance was good in patients with dementia (sensitivity and specificity, 96 and 86%, respectively) and in those without dementia (sensitivity and specificity, 93 and 96%, respectively).

“The 3D-CAM operationalizes the CAM algorithm using a three-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium,” the authors write.


  1. Marcantonio ER et al. Ann Intern Med. 2014; doi:10.7326/M14-0865