Confusion Assessment Method-Diagnostic Algorithm (CAM) is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IIIR) criteria for delirium, is a sensitive and specific four item diagnostic algorithm that enables data collectors without formal psychiatric training to quickly and accurately identify delirium in hospitalized older adults.Patients are identified as positive for delirium if three of the four following elements are present as reported by caregivers (acute onset and fluctuating course, altered level of consciousness, disorganized thinking, inattention).

Who created the instrument? Who maintains it?

Frequency/Level of use, dissemination, how widespread is the usage of the instrument?

For what population was the instrument designed?

Who is the instrument administered to?

Where is the instrument used i.e. admission to nursing home, referral to home care, etc?

Is this insrument derived from or a component of another instrument?

The CAM’s sensitivity has been reported to be between 0.94 –1.00, specificity between 0.90 – 0.95, and inter-observer reliability of , 0.81 – 1.0.

What domains does the instrument assess? List CCD topics that the instrument covers.

Is subject just asked questions or do they have to do some activity (i.e. get up and go assessment)?

An algorithm may calculate one or more scores based on elements of the assessment.

Is the instrument being used outside the original target population?

Are there different versions of the tool? Sometimes the different versions have different # of questions.

Is the instrument in the public domain (Y/N)?

Pompei P, Foreman M, Cassel CK, Alessi C, Cox D. Detecting delirium among hospitalized older patients. Arch Intern Med. Feb 13 1995;155(3):301-307.

www.elderlife.med.yale.edu/pdf

Discussion