An abbreviated version of the Confusion Assessment Method, or CAM, test is highly sensitive and specific for diagnosing delirium, according to a study being published in Annals of Internal Medicine.
Delirium is common in hospitalized older patients but it often goes undiagnosed. Widely used since the 1990s, the CAM test is regarded as an accurate assessment tool for delirium. However, the CAM is challenging to use in clinical settings because it requires cognitive assessment and significant training for the interviewer. Seeking to develop a shorter method of diagnosing delirium using the CAM algorithm, researchers developed the 3D-CAM, a short, structured diagnostic assessment that can be administered by health care staff with minimal training.
Psychologists and advanced practice nurses conducted a face-to-face standard assessment for delirium in 201 patients, taking approximately 1.5 hours to complete. A 3D-CAM assessment was also completed for each participant, and a second 3D-CAM assessment was done in half of the participants chosen at random. Compared with the reference standard for diagnosis delirium, the 3D-CAM was 96 percent sensitive and 98 percent specific. The authors concluded that 3D-CAM is quick to complete, highly reproducible and a valid tool for diagnosising delirium.
Study: 3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium: A Cross-sectional Diagnostic Test Study, Edward R. Marcantonio, MD, SM; Long H. Ngo, PhD; Margaret O'Connor, PhD; Richard N. Jones, ScD; Paul K. Crane, MD, MPH; Eran D. Metzger, MD; and Sharon K. Inouye, MD, MPH, Annals of Internal Medicine, doi:10.7326/M14-0865, published 21 October 2014.