{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:46:59Z","timestamp":1782186419872,"version":"3.54.5"},"reference-count":81,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing &amp;amp; Health Sciences"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Delirium is a common, critical condition in adults receiving care in intensive care units, requiring effective screening tools for early detection. To systematically compare the diagnostic performance of delirium screening tools for adults receiving care in ICUs, we conducted a comprehensive search across nine databases up to August 1, 2025, followed by a network meta\u2010analysis of diagnostic test accuracy. Fifty studies involving 6042 patients were included. The S\u2010PTD demonstrated optimal diagnostic performance, with high pooled sensitivity (0.922) and specificity (0.977). The CAM\u2010ICU showed outstanding specificity (0.949), whereas the DDS exhibited poor sensitivity (0.302). In conclusion, the CAM\u2010ICU and ICDSC are widely used; the S\u2010PTD performs excellently but requires validation in adults receiving mechanical ventilation, and the 4AT exhibits balanced accuracy but is unsuitable for adults receiving mechanical ventilation. The NEECHAM and DDS have limitations, particularly the DDS, which exhibits low sensitivity and may fail to accurately identify cases of delirium. High\u2010quality validation studies and uniform DSM\u20105 use are recommended.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    This study has been registered with PROSPERO (CRD42024534483)\n                  <\/jats:p>","DOI":"10.1111\/nhs.70344","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:33:42Z","timestamp":1777883622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Screening Tools for Delirium in Adults Receiving Care in Intensive Care Units: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"28","author":[{"given":"Ning","family":"Li","sequence":"first","affiliation":[{"name":"School of Nursing Gansu University of Traditional Chinese Medicine  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiying","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Nursing Gansu University of Traditional Chinese Medicine  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Nursing Gansu University of Traditional Chinese Medicine  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6607-9900","authenticated-orcid":false,"given":"Xiaoyan","family":"Xu","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Gansu University of Chinese Medicine  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2012.02.003"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610217001697"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003643-200505001-00602"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010018\u20101676\u20100"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2018.08.009"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.08.025"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010071\u201023853"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.10.013"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182783b72"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)00516\u20104"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010020\u201002622\u2010z"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340100909"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2018.14597"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951516001176"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2025.123619"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010018\u20100377\u20107"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103782"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648211067526"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000168"},{"key":"e_1_2_15_21_1","doi-asserted-by":"crossref","unstructured":"Deeks J. J. B. P. M. M.Leeflang andY.Takwoingi.2024.\u201cCochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy (version2).\u201dAccessed May 10 2024.https:\/\/methods.cochrane.org\/sdt\/handbook\u2010dta\u2010reviews.","DOI":"10.1002\/9781119756194"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.48.5.436"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCC.0b013e318256e0cc"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010200107000\u201000012"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20220334"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2017.03.004"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3964-1"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2009.08.005"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11407"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1590\/s1807\u201059322011001100011"},{"key":"e_1_2_15_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001378"},{"key":"e_1_2_15_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u2010244X\u201011\u201094"},{"key":"e_1_2_15_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2019.11.001"},{"key":"e_1_2_15_35_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20102385"},{"key":"e_1_2_15_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472\u20106955\u20104\u20107"},{"key":"e_1_2_15_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaclp.2023.09.004"},{"key":"e_1_2_15_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44250\u2010024\u201000099\u20101"},{"key":"e_1_2_15_39_1","doi-asserted-by":"publisher","DOI":"10.5530\/ami.2016.2.15"},{"key":"e_1_2_15_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2014.10.002"},{"key":"e_1_2_15_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/2047\u20103095.12090"},{"key":"e_1_2_15_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.01.017"},{"key":"e_1_2_15_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003402"},{"key":"e_1_2_15_44_1","unstructured":"Li L. Q. andJ. N.Wang.2020.\u201cThe Validity and Reliability Test of Chinese Version 4AT and 3D\u2010CAM for Assessment of Delirium in ICU Patients [in Chinese].\u201dNanchang University https:\/\/link.cnki.net\/doi\/10.27232\/d.cnki.gnchu.2020.000796."},{"key":"e_1_2_15_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000145587.16421.BB"},{"key":"e_1_2_15_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.28776"},{"key":"e_1_2_15_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cabb42"},{"key":"e_1_2_15_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111757"},{"key":"e_1_2_15_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000284506.43390.f3"},{"key":"e_1_2_15_50_1","doi-asserted-by":"publisher","DOI":"10.7326\/AITC202010060"},{"key":"e_1_2_15_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010014\u20100164\u20108"},{"key":"e_1_2_15_52_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56080411"},{"key":"e_1_2_15_53_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1672\u20107088.2014.07.006"},{"key":"e_1_2_15_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2015.11.001"},{"key":"e_1_2_15_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae129"},{"key":"e_1_2_15_56_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_15_57_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S62660"},{"key":"e_1_2_15_58_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100029\u20101202647"},{"key":"e_1_2_15_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20050"},{"key":"e_1_2_15_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1036\u20107314(05)80019\u20100"},{"key":"e_1_2_15_61_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010071\u201024809"},{"key":"e_1_2_15_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.12.011"},{"key":"e_1_2_15_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010016\u20100878\u20106"},{"key":"e_1_2_15_64_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739\u2010024\u201003670\u2010z"},{"key":"e_1_2_15_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010015\u20100004\u20108"},{"key":"e_1_2_15_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae159"},{"key":"e_1_2_15_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2020.12.008"},{"key":"e_1_2_15_68_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa224"},{"key":"e_1_2_15_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2009.04.003"},{"key":"e_1_2_15_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2011.05.015"},{"key":"e_1_2_15_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2009.07.002"},{"key":"e_1_2_15_72_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101\u20100065OC"},{"key":"e_1_2_15_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a00118"},{"key":"e_1_2_15_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.02.001"},{"issue":"2","key":"e_1_2_15_75_1","first-page":"73","article-title":"Validation of the Dutch Version of the Confusion Assessment Method (CAM\u2010ICU) for Delirium Screening in the Intensive Care Unit","volume":"13","author":"Vreeswijk R.","year":"2009","journal-title":"Netherlands Journal of Critical Care"},{"key":"e_1_2_15_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2012.10.004"},{"key":"e_1_2_15_77_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1672\u20107088.2013.30.006"},{"key":"e_1_2_15_78_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028\u2010021\u201001319\u20109"},{"key":"e_1_2_15_79_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010155\u20108\u2010201110180\u201000009"},{"key":"e_1_2_15_80_1","unstructured":"World Bank.2024.\u201cWorld Bank Country and Lending Groups.\u201dhttps:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519."},{"key":"e_1_2_15_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.103886"},{"key":"e_1_2_15_82_1","unstructured":"Zhang Q.2021.\u201cA Systematic Study on the Accuracy of ICU Delirium Screening Tools [in Chinese].\u201dLanzhou University.https:\/\/doi.org\/10.27204\/d.cnki.glzhu.2021.002548."}],"container-title":["Nursing &amp; Health Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nhs.70344","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:53:24Z","timestamp":1782183204000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nhs.70344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":81,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/nhs.70344"],"URL":"https:\/\/doi.org\/10.1111\/nhs.70344","archive":["Portico"],"relation":{},"ISSN":["1441-0745","1442-2018"],"issn-type":[{"value":"1441-0745","type":"print"},{"value":"1442-2018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"2025-03-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70344"}}