The 4AT tool

The diagnostic accuracy of the 4AT has been assessed in many studies, 17 of which have been collectively analyzed in a systematic review and meta-analysis.³ The 17 studies varied; some studies included translated or modified versions of the original 4AT tool, and were in different patient settings.³ The studies reported a range of delirium prevalence ranging from 10.5–61.9%.3 Some of these validation studies were in acute stroke.³ In a pre-planned subgroup analysis, the sensitivity and specificity of the 4AT in patients with stroke (0.86 and 0.89, respectively) were similar to the values for the total population (0.88 and 0.88, as shown on the slide).³

References:
1. 4AT website. Available at: https://www.the4at.com. Accessed May 2023.

2. Anand A, Cheng M, Ibitoye T, et al. Positive scores on the 4AT delirium assessment tool at hospital admission are linked to mortality, length of stay and home time: two-centre study of 82,770 emergency admissions. Age Ageing 2022; 51 (3): afac051.

3. Tieges Z, Maclullich AMJ, Anand A, et al. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age Ageing 2021; 50 (3): 733–743.