OBJECTIVES: To examine the psychometric properties, adaptations, translations, and applications of the Confusion Assessment Method (CAM), a widely used instrument and diagnostic algorithm for identification of delirium. DESIGN: Systematic literature review. SETTING: Not applicable. MEASUREMENTS: Electronic searches of PubMED, EMBASE, PsychINFO, CINAHL, Ageline, and Google Scholar, augmented by reviews of reference listings, were conducted to identify original English-language articles using the CAM from January 1, 1991, to December 31, 2006. Two reviewers independently abstracted key information from each article. PARTICIPANTS: Not applicable. RESULTS: Of 239 original articles, 10 (4%) were categorized as validation studies, 16 (7%) as adaptations, 12 (5%) as translations, and 222 (93%) as applications. Validation studies evaluated performance of the CAM against a reference standard. Results were combined across seven high-quality studies (N=1,071), demonstrating an overall sensitivity of 94% (95% confidence interval (CI)=91-97%) and specificity of 89% (95% CI=85-94%). The CAM has been adapted for use in the intensive care unit, emergency, and institutional settings and for scoring severity and subsyndromal delirium. The CAM has been translated into 10 languages where published articles are available. In application studies, CAM-rated delirium is most commonly used as a risk factor or outcome but also as an intervention or reference standard. CONCLUSION: The CAM has helped to improve identification of delirium in clinical and research settings. To optimize performance, the CAM should be scored based on observations made during formal cognitive testing, and training is recommended. Future action is needed to optimize use of the CAM and to improve the recognition and management of delirium.
OBJECTIVES: To examine the psychometric properties, adaptations, translations, and applications of the Confusion Assessment Method (CAM), a widely used instrument and diagnostic algorithm for identification of delirium. DESIGN: Systematic literature review. SETTING: Not applicable. MEASUREMENTS: Electronic searches of PubMED, EMBASE, PsychINFO, CINAHL, Ageline, and Google Scholar, augmented by reviews of reference listings, were conducted to identify original English-language articles using the CAM from January 1, 1991, to December 31, 2006. Two reviewers independently abstracted key information from each article. PARTICIPANTS: Not applicable. RESULTS: Of 239 original articles, 10 (4%) were categorized as validation studies, 16 (7%) as adaptations, 12 (5%) as translations, and 222 (93%) as applications. Validation studies evaluated performance of the CAM against a reference standard. Results were combined across seven high-quality studies (N=1,071), demonstrating an overall sensitivity of 94% (95% confidence interval (CI)=91-97%) and specificity of 89% (95% CI=85-94%). The CAM has been adapted for use in the intensive care unit, emergency, and institutional settings and for scoring severity and subsyndromal delirium. The CAM has been translated into 10 languages where published articles are available. In application studies, CAM-rated delirium is most commonly used as a risk factor or outcome but also as an intervention or reference standard. CONCLUSION: The CAM has helped to improve identification of delirium in clinical and research settings. To optimize performance, the CAM should be scored based on observations made during formal cognitive testing, and training is recommended. Future action is needed to optimize use of the CAM and to improve the recognition and management of delirium.
Authors: Judith Jacobi; Gilles L Fraser; Douglas B Coursin; Richard R Riker; Dorrie Fontaine; Eric T Wittbrodt; Donald B Chalfin; Michael F Masica; H Scott Bjerke; William M Coplin; David W Crippen; Barry D Fuchs; Ruth M Kelleher; Paul E Marik; Stanley A Nasraway; Michael J Murray; William T Peruzzi; Philip D Lumb Journal: Crit Care Med Date: 2002-01 Impact factor: 7.598
Authors: E W Ely; S K Inouye; G R Bernard; S Gordon; J Francis; L May; B Truman; T Speroff; S Gautam; R Margolin; R P Hart; R Dittus Journal: JAMA Date: 2001-12-05 Impact factor: 56.272
Authors: Arti Hurria; Ilene S Browner; Harvey Jay Cohen; Crystal S Denlinger; Mollie deShazo; Martine Extermann; Apar Kishor P Ganti; Jimmie C Holland; Holly M Holmes; Mohana B Karlekar; Nancy L Keating; June McKoy; Bruno C Medeiros; Ewa Mrozek; Tracey O'Connor; Stephen H Petersdorf; Hope S Rugo; Rebecca A Silliman; William P Tew; Louise C Walter; Alva B Weir; Tanya Wildes Journal: J Natl Compr Canc Netw Date: 2012-02 Impact factor: 11.908
Authors: Babar A Khan; Mohammed Zawahiri; Noll L Campbell; George C Fox; Eric J Weinstein; Arif Nazir; Mark O Farber; John D Buckley; Alasdair Maclullich; Malaz A Boustani Journal: J Hosp Med Date: 2012-06-08 Impact factor: 2.960
Authors: M P Ntalouka; M Bareka; A G Brotis; A Chalkias; K Stamoulis; A Flossos; P Tzimas; E Arnaoutoglou Journal: Hippokratia Date: 2020 Jan-Mar Impact factor: 0.471
Authors: Tammy T Hshieh; Tamara G Fong; Eva M Schmitt; Edward R Marcantonio; Madeline L D'Aquila; Jacqueline Gallagher; Guoquan Xu; Yun R Guo; Tatiana F Abrantes; Sylvie E Bertrand; Richard N Jones; Sharon K Inouye Journal: Gerontology Date: 2018-07-20 Impact factor: 5.140
Authors: Melinda R Steis; Lois Evans; Karen B Hirschman; Alexandra Hanlon; Donna M Fick; Nina Flanagan; Sharon K Inouye Journal: J Am Geriatr Soc Date: 2012-10-05 Impact factor: 5.562
Authors: Dan K Kiely; Edward R Marcantonio; Sharon K Inouye; Michele L Shaffer; Margaret A Bergmann; Frances M Yang; Michael A Fearing; Richard N Jones Journal: J Am Geriatr Soc Date: 2009-01 Impact factor: 5.562