Delirium is a common condition that often goes unnoticed in clinical settings, with detection rates ranging from 12-35%. Delirium is a sudden change in a person’s thinking ability, and its consequences can be devastating. To help combat this issue, the 3D-CAM: the 3-Minute Diagnostic Interview for Confusion Assessment Method (CAM) defined delirium, was developed with support from the National Institute on Aging.
The 3D-CAM is a short interview that can be completed in a median of 3 minutes and has excellent diagnostic test characteristics with a sensitivity of 95% and specificity of 94% compared to a reference standard based on an extensive clinical evaluation. It was developed using sophisticated measurement and biostatistics methods to identify the best assessment items for each of the four diagnostic features of delirium in the CAM.
The 3D-CAM is designed to provide an efficient and reliable way to determine if a patient is delirious. By using verbal responses and allowing completion of the CAM diagnostic algorithm, the 3D-CAM provides a short, reproducible method for detecting delirium. Its use facilitates needed systematic case-finding for delirium among vulnerable hospitalized elders.
To assist in the use of the 3D-CAM in clinical practice, a user’s guide is provided in this manual. The guide includes specifics for delirium assessment, item by item guidance, scoring instructions, a flow diagram, supplemental skip pattern instructions, and ten tips for delirium interview success. The manual also includes the 3D-CAM instrument for clinical use.
The 3D-CAM Training Manual was developed incorporating information and materials from several sources, including the Confusion Assessment Method (CAM) Training Manual and Coding Guide, the Short CAM Training Manual and Coding Guide, and The SAGES Study: Training Manual and Questionnaires.
The 3D-CAM instrument and its associated user’s guide provide a valuable tool for clinicians to accurately and efficiently diagnose delirium in their patients. This tool can help prevent the devastating consequences that can occur when delirium goes undetected. Clinicians are encouraged to use this manual in any way that fits the needs of their team, and feedback is welcomed to improve the manual’s effectiveness.