Related Experiment Video
Updated: Jun 23, 2026
12:18
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Targeted Delirium Screening in At-risk Older Adults in the Emergency Department Improves Screening Rates
Saket A Saxena1, Emily H Weaver2, Evelyn C Brady2
1Center for Geriatric Medicine, Desk X10, Cleveland Clinic, Cleveland, Ohio, USA.
Summary
Implementing electronic medical record (EMR)-based risk stratification significantly increased delirium screening in the emergency department (ED). This targeted approach identified more patients with subtle delirium compared to traditional methods.
Area of Science:
- Emergency Medicine
- Geriatrics
- Neuroscience
Background:
- Delirium is common but often missed in emergency departments (EDs).
- Systematic delirium screening in the ED is not widely implemented.
- Early identification of delirium is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the impact of electronic medical record (EMR)-based risk stratification on delirium screening rates and positivity in the ED.
- To compare delirium screening outcomes between a clinical judgment-based approach and an EMR-targeted approach.
Main Methods:
- A multicenter study comparing two periods: baseline (clinical judgment/age-based screening) and intervention (EMR-based risk stratification).
- The 4AT tool was used for delirium screening in both periods.
- Analysis of screening rates, positivity rates, and score distribution.
Main Results:
- The EMR-based approach increased eligible screenings by sixfold (39,065 vs. 3,267 encounters).
- Screening rates increased significantly (14,125 vs. 2,241 patients screened).
- The risk-stratified approach identified more patients with subtle delirium (lower positive 4AT scores).
Conclusions:
- EMR-based risk stratification is a feasible method for targeted delirium screening at ED triage.
- Combining risk-stratified screening with clinical judgment may improve delirium detection.
- Targeted screening enhances the identification of delirium, including milder forms.
