Delirium Assessment Caveats

Over the past 3 decades, numerous delirium assessments have been developed and validated to be used by nonpsychiatrists. However, there is no perfect delirium assessment as they all have tradeoffs.

• Increasing brevity and feasibility results in loss of diagnostic accuracy
• If there is a loss in diagnostic accuracy, achieving high sensitivity usually results in a loss in specificity and vice versa

In general, if a delirium assessment is brief (<2 minutes), then you will have to sacrifice diagnostic accuracy. Delirium assessments with high diagnostic accuracy (>90% sensitivity and 90% specificity) typically take longer to perform and require extensive training to perform reliably. Briefer and simpler-to-use delirium assessments often sacrifice diagnostic accuracy. If diagnostic accuracy is sacrificed, then sensitivity is often sacrificed for specificity and vice versa.