DIAGNOSING DELIRIUM BY TELEPHONE

To determine whether delirium can be diagnosed by telephone, we interv iewed 41 subjects aged 65 years or older 1 month after repair of hip f racture, first by telephone and then face-to-face. Interviews included the modified telephone Mini-Mental State Examination and the Delirium Symptom Interview. Delirium was diagnosed using the Confusion Assessm ent Method diagnostic algorithm. and the telephone results were compar ed with the face-to-face results (the ''gold standard''). Of 41 subjec ts, 6 were delirious by face-to-face assessment; all 6 were delirious by telephone (sensitivity 1.00). Of 35 patients not delirious by face- to-face assessment, 33 patients were not delirious by telephone (speci ficity = 0.94). We conclude that telephone interviews can effectively rule out delirium, but the positive diagnosis should be confirmed by a face-to-face assessment, especially in populations with a low prevale nce of delirium.