The Confusion Assessment Method: a systematic review of current usage

Area of Science:

• Gerontology
• Psychiatry
• Critical Care Medicine

Background:

• Delirium is a common and serious condition in various healthcare settings.
• Accurate identification of delirium is crucial for timely intervention and improved patient outcomes.
• The Confusion Assessment Method (CAM) is a widely utilized tool for delirium diagnosis.

Purpose of the Study:

• To systematically review the psychometric properties of the Confusion Assessment Method (CAM).
• To examine adaptations, translations, and diverse applications of the CAM in different settings.
• To evaluate the overall performance and utility of the CAM in identifying delirium.

Main Methods:

• A systematic literature review was conducted.
• Searches included major databases (PubMed, EMBASE, PsycINFO, CINAHL, Ageline, Google Scholar) from 1991 to 2006.
• Two independent reviewers extracted data from identified articles.

Main Results:

• Out of 239 articles, 10 were validation studies, 16 adaptations, 12 translations, and 222 applications.
• Seven validation studies (N=1,071) showed high pooled sensitivity (94%) and specificity (89%) for the CAM.
• The CAM has been adapted for ICUs, emergency settings, and translated into 10 languages.

Conclusions:

• The CAM has significantly improved delirium identification in clinical and research environments.
• Optimal CAM performance is achieved through formal cognitive testing and recommended training.
• Further efforts are needed to refine CAM utilization for enhanced delirium recognition and management.