REFERENCES

4AT diagnostic test accuracy studies

31. Fabrizi D, Rebora P, Spedale V, Locatelli G, Bellelli G, Di Mauro S, Ausili D, Luciani M. Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study. Healthcare (Basel). 2024 Jun 28;12(13):1294.

30. Sim JK, Chung K, Chung CR, Lee J, Hwang SY, Lee YS. Usefulness of the 4A's test for detecting delirium in critically ill patients: a multicenter prospective observation study. Intern Emerg Med. 2024 Oct;19(7):1839-1846.

29. Arnold E, Finucane AM, Taylor S, Spiller JA, O'Rourke S, Spenceley J, Carduff E, Tieges Z, MacLullich AM. The 4AT, a rapid delirium detection tool for use in hospice inpatient units: Findings from a validation study. Palliat Med. 2024 May;38(5):535-545. doi: 10.1177/02692163241242648. PMID: 38767241.

28. Soler-Sanchis A, Martínez-Arnau FM, Sánchez-Frutos J, Pérez-Ros P. The 4AT scale for rapid detection of delirium in emergency department triage. Front Med (Lausanne). 2024 May 14;11:1345983.

27. Morales-Puerto M, Ruiz-Díaz M, García-Mayor S, León-Campos Á, Morales-Asencio JM, Canca-Sánchez JC, Gavira-Guerra S, Toledo-Fernandez C, Aranda-Gallardo M. Spanish transcultural adaptation of the 4AT score for the evaluation of delirium in the emergency department: a prospective diagnostic test accuracy study. BMC Nurs. 2024 Feb 6;23(1):101. doi: 10.1186/s12912-023-01638-6.

26. Pouw MA, Calf AH, Georg RR, de Rooij SE, Ter Maaten JC, van Munster BC. Diagnostic accuracy of the Dutch version of the 4AT for delirium detection in a mixed patient population and setting. Aging Clin Exp Res. 2023 Aug;35(8):1705-1710.

25. Muzzana C, Mantovan F, Tappeiner W, Niederbacher S, Huber MK, Ausserhofer D. Interrater Reliabilität und Übereinstimmungsvalidität des 4AT zur Erfassung des postoperativen Delirs [Interrater reliability and concurrent validity of 4AT for the detection of postoperative delirium: A prospective cohort study]. Pflege. 2023 Aug;36(4):189-197. German.

24. Delgado-Parada E, Morillo-Cuadrado D, Saiz-Ruiz J, Cebollada-Gracia A, Ayuso-Mateos JL, Cruz-Jentoft AJ. Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients. European Journal of Psychiatry. 2022 36(3):182-90

23. Aldwikat RK, Manias E, Holmes A, Tomlinson E, Nicholson P. Validation of Two Screening Tools for Detecting Delirium in Older Patients in the Post-Anaesthetic Care Unit: A Diagnostic Test Accuracy Study. Int J Environ Res Public Health. 2022 Nov 30;19(23):16020.

22. Hur HJ, Jang YN, Park HY, Lee YS, Ro DH, Kang B, Song KH, Park HY. A prospective study of remote delirium screening using the modified K-4AT for COVID-19 inpatients. Front Psychiatry. 2022 Aug 18;13:976228.

21. Hasegawa T, Seo T, Kubota Y, Sudo T, Yokota K, Miyazaki N, Muranaka N, Hirano S, Yamauchi A, Nagashima K, Iyo M, Sakai I. Reliability and validity of the Japanese version of the 4A's Test for delirium screening in the elderly patient. Asian Journal of Psychiatry, 2021, 102918.

20. Evensen S, Hylen Ranhoff A, Lydersen S, Saltvedt I. The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity. Eur Geriatr Med. 2021 Aug;12(4):793-800.

19. Johansson YA, Tsevis T, Nasic S, Gillsjö C, Johansson L, Bogdanovic N, Kenne Sarenmalm E. Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting. BMC Geriatr. 2021 Oct 18;21(1):568.

18. Evensen S, Hylen Ranhoff A, Lydersen S, Saltvedt I. The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity. Eur Geriatr Med. 2021 Aug;12(4):793-800.

17. Chang Y, Ragheb SM, Oravec N, Kent D, Nugent K, Cornick A, Hiebert B, Rudolph JL, MacLullich AMJ, Arora RC. Diagnostic accuracy of the "4 A's Test" delirium screening tool for the postoperative cardiac surgery ward. J Thorac Cardiovasc Surg. 2021 Jun 1:S0022-5223(21)00876-X.

16. Sepúlveda E, Bermúdez E, González D, Cotino P, Viñuelas E, Palma J, Ciutat M, Grau I, Vilella E, Trzepacz PT, Franco JG. Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 'A's test (4AT). Gen Hosp Psychiatry. 2021 May-Jun;70:116-123.

15. Shenkin SD, Fox C, Godfrey M, Siddiqi N, Goodacre S, Young J, Anand A, Gray A, Hanley J, MacRaild A, Steven J, Black PL, Tieges Z, Boyd J, Stephen J, Weir CJ, MacLullich AMJ. Delirium detection in older acute medical inpatients: a multicentre prospective comparative diagnostic test accuracy study of the 4AT and the Confusion Assessment Method. BMC Med. 2019 Jul 24;17(1):138

14. Myrstad M, Watne LO, Johnsen NT, Børs-Lind E, Neerland BE. Delirium screening in an acute geriatric ward by nurses using 4AT: results from a quality improvement project. Eur Geriatr Med. 2019 Aug;10(4):667-671.

13. Saller T, MacLullich AMJ, Schäfer ST, Crispin A, Neitzert R, Schüle C, von Dossow V, Hofmann-Kiefer KF. Screening for delirium after surgery: validation of the 4 A's test (4AT) in the post-anaesthesia care unit. Anaesthesia. 2019;74:1260-1266

12. Gagné AJ, Voyer P, Boucher V, Nadeau A, Carmichael PH, Pelletier M, Gouin E, Berthelot S, Daoust R, Wilchesky M, Richard H, Pelletier I, Ballard S, Laguë A, Émond M. Performance of the French version of the 4AT for screening the elderly for delirium in the emergency department. CJEM. 2018 Nov;20:903-910

11. O'Sullivan D, Brady N, Manning E, O'Shea E, O'Grady S, O 'Regan N, Timmons S. Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees. Age Ageing. 2018; 47:61-68

10. Al-Jumayli M, Hiner JA, Taffet GE, Agarwal KS. Use of the 4AT to detect delirium in older hospitalized cancer patients. J Am Geriatr Soc 2018; 66: S33. Abstract image.

9. Infante MT, Pardini M, Balestrino M, Finocchi C, Malfatto L, Bellelli G, Mancardi GL, Gandolfo C, Serrati C. Delirium in the acute phase after stroke: comparison between methods of detection. Neurol Sci. 2017; 386:1101-1104

8. De J, Wand AP, Smerdely PI, Hunt GE. Validating the 4A's test in screening for delirium in a culturally diverse geriatric inpatient population. Int J Geriatr Psychiatry. 2017; 32:1322-1329

7. Hendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, Cunnington A, Stott DJ. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age Ageing. 2016; 45:832-837

6. Kazim R, MacLullich AMJ, Taffet GE, Agarwal KS. 4AT screening tool used by nurses is both sensitive and specific for detection of delirium in hospitalized elders. 7th Annual Meeting of the American Delirium Society; 2016; Nashville, Tennessee, USA.

5. Kuladee S, Prachason T. Development and validation of the Thai version of the 4 'A's Test for delirium screening in hospitalized elderly patients with acute medical illnesses. Neuropsychiatr Dis Treat. 2016; 12:437-43

4. Asadollahi A, Saberi M, Entezari M, Hoseini Z, Hasani SA, Saberi LF. Iranian version of 4AT, an instrument for rapid delirium screening for later life. Int J Adv Appl Sci 2016; 3: 33–8.

3. Kutlubaev MA, Bikbulatova LF, Akhmadeeva LR. [Early diagnosing of delirium in the elderly with acute stroke]. Advances in gerontology = Uspekhi gerontologii. 2015;28(3):493-9. [Russian]

2. Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S, Ryan T, Cash H, Guerini F, Torpilliesi T, Del Santo F, Trabucchi M, Annoni G, MacLullich AM. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014; 43:496-502

1. Lees R, Corbet S, Johnston C, Moffitt E, Shaw G, Quinn TJ. Test accuracy of short screening tests for diagnosis of delirium or cognitive impairment in an acute stroke unit setting. Stroke. 2013; 44:3078-83

systematic reviews which include the 4at

Carpenter CR, Lee S, Kennedy M, Arendts G, Schnitker L, Eagles D, Mooijaart S, Fowler S, Doering M, LaMantia MA, Han JH, Liu SW. Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments. Acad Emerg Med. 2024 Oct;31(10):1014-1036.

Penfold RS, Squires C, Angus A, Shenkin SD, Ibitoye T, Tieges Z, Neufeld KJ, Avelino-Silva TJ, Davis D, Anand A, Duckworth AD, Guthrie B, MacLullich AMJ. Delirium detection tools show varying completion rates and positive score rates when used at scale in routine practice in general hospital settings: A systematic review. J Am Geriatr Soc. 2024 Jan 19. doi: 10.1111/jgs.18751.

Lin CJ, Su IC, Huang SW, Chen PY, Traynor V, Chang HR, Liu IH, Lai YS, Lee HC, Rolls K, Chiu HY. Delirium assessment tools among hospitalized older adults: A systematic review and metaanalysis of diagnostic accuracy. Ageing Res Rev. 2023 Sep;90:102025.

Liu Y, Li Z, Li Y, Ge N, Yue J. Detecting delirium: a systematic review of ultrabrief identification instruments for hospital patients. Front Psychol. 2023 May 12;14:1166392.

Hou L, Zhang Q, Cao L, Chen M, Wang Q, Li Y, Li S, Ge L, Yang K. Diagnostic accuracy of the 4AT for delirium: A systematic review and meta-analysis. Asian J Psychiatr. 2023 Feb;80:103374.

Aldwikat RK, Manias E, Tomlinson E, Amin M, Nicholson P. Delirium screening tools in the post-anaesthetic care unit: a systematic review and meta-analysis. Aging Clin Exp Res. 2022 Jan 3.

Bridwell RE, April MD, Long B. Is the 4AT Score Accurate in Identifying Delirium in Older Adults? Ann Emerg Med. 2021 Jun;77(6):628-630.

Mansutti I, Saiani L, Palese A. Detecting delirium in patients with acute stroke: a systematic review of test accuracy. BMC Neurol. 2019;19(1):310. Published 2019 Dec 2.

Tieges Z, MacLullich AMJ, Anand A, Brookes C, Cassarino M, O'connor M, Ryan D, Saller T, Arora RC, Chang Y, Agarwal K, Taffet G, Quinn T, Shenkin SD, Galvin R. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age Ageing. 2021 May 5;50(3):733-743.

Calf AH, Pouw MA, van Munster BC, Burgerhof JGM, de Rooij SE, Smidt N. Screening instruments for cognitive impairment in older patients in the Emergency Department: a systematic review and meta-analysis. Age Ageing. 2021 Jan 8;50(1):105-112.

Jeong E, Park J, Lee J. Diagnostic Test Accuracy of the 4AT for Delirium Detection: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 Oct 15;17(20):7515.

Mansutti I, Saiani L, Palese A. Detecting delirium in patients with acute stroke: a systematic review of test accuracy. BMC Neurol. 2019 Dec 2;19(1):310.

studies using the 4AT in routine practice

Penfold RS, Hall AJ, Anand A, Clement ND, Duckworth AD, MacLullich AMJ. Delirium in hip fracture patients admitted from home during the COVID-19 pandemic is associated with higher mortality, longer total length of stay, need for post-acute inpatient rehabilitation, and readmission to acute services. Bone Jt Open. 2023 Jun 16;4(6):447-456.

Hawley S, Inman D, Gregson CL, Whitehouse M, Johansen A, Judge A. Risk Factors and 120-Day Functional Outcomes of Delirium After Hip Fracture Surgery: A Prospective Cohort Study Using the UK National Hip Fracture Database (NHFD). J Am Med Dir Assoc. 2023 May;24(5):694-701.e7.

Ihle-Hansen H, Johnsen N, Jankowiak T, Hagberg G, Walle-Hansen MM, Landgraff I, Høvik G, Graven E, Myrstad M. Delirium screening in a stroke unit by nurses using 4AT: Results from a quality improvement project. Nurs Open. 2023 Nov;10(11):7431-7436.

Anand A, Cheng M, Ibitoye T, Maclullich AMJ, Vardy ERLC. 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 and Ageing. 2022 51 (3).

Beretta M, Uggeri S, Santucci C, Cattaneo M, Ermolli D, Gerosa C, Ornaghi M, Roccasalva A, Santambrogio P, Varrassi G, Corli O. Early Diagnosis of Delirium in Palliative Care Patients Decreases Mortality and Necessity of Palliative Sedation: Results of a Prospective Observational Study. Cureus. 2022 Jun 7;14(6):e25706.

Cullum S, Kubba Y, Varghese C, Coomarasamy C, Hopkins J. The evidence for introducing case-finding for delirium and dementia in older medical inpatients in a New Zealand hospital. Australas Psychiatry. 2022 Jun;30(3):303-307.

Myrstad M, Kuwelker K, Haakonsen S, Valebjørg T, Langeland N, Kittang BR, Hagberg G, Neerland BE, Bakken MS. Delirium screening with 4AT in patients aged 65 years and older admitted to the Emergency Department with suspected sepsis: a prospective cohort study. Eur Geriatr Med. 2022 Feb;13(1):155-162.

Alhaidari AAO, Matsis KP. Barriers to completing the 4AT for delirium and its clinical implementation in two hospitals: a mixed-methods study. Eur Geriatr Med. 2021 Nov 16.

Matharu GS, Shah A, Hawley S, Johansen A, Inman D, Moppett I, Whitehouse MR, Judge A. The influence of mode of anaesthesia on perioperative outcomes in people with hip fracture: a prospective cohort study from the National Hip Fracture Database for England, Wales and Northern Ireland. BMC Med. 2022 Sep 26;20(1):319. doi: 10.1186/s12916-022-02517-8.

Tieges Z, Lowrey J, MacLullich AMJ. What delirium detection tools are used in routine clinical practice in the United Kingdom? Survey results from 91% of acute healthcare organisations. Eur Geriatr Med. 2021 May 18.

O'Shaughnessy Í, Romero-Ortuno R, Edge L, Dillon A, Flynn S, Briggs R, Shields D, McMahon G, Hennessy A, Kennedy U, Staunton P, McNamara R, Timmons S, Horgan F, Cunningham C. Home FIRsT: interdisciplinary geriatric assessment and disposition outcomes in the Emergency Department. Eur J Intern Med. 2020 Nov 23:S0953-6205(20)30425-8.

Vardy E, Collins N, Grover U, et al. Use of a digital delirium pathway and quality improvement to improve delirium detection in the emergency department and outcomes in an acute hospital. Age Ageing. 2020;49(4):672-678.

Lisk R, Yeong K, Enwere P, Jenkinson J, Robin J, Irvin-Sellers M, Fluck D, Osmani A, Sharmin R, Sharma P, Fry CH, Han TS. Associations of 4AT with mobility, length of stay and mortality in hospital and discharge destination among patients admitted with hip fractures. Age Ageing. 2020 Apr 27;49(3):411-417.

Dormandy L, Mufti S, Higgins E, Bailey C, Dixon M. Shifting the focus: A QI project to improve the management of delirium in patients with hip fracture. Future Healthc J. 2019;6:215-219

Mossello E, Tesi F, Di Santo SG, Mazzone A, Torrini M, Cherubini A, Bo M, Musicco M, Bianchetti A, Ferrari A, Ferrara N, Trabucchi M, Morandi A, Bellelli G; Italian Study Group on Delirium. Recognition of Delirium Features in Clinical Practice: Data from the "Delirium Day 2015" National Survey. J Am Geriatr Soc. 2018;66:302-308

Bauernfreund Y, Butler M, Ragavan S, Sampson EL. TIME to think about delirium: improving detection and management on the acute medical unit. BMJ Open Qual. 2018 Aug 13;7(3):e000200

Morandi A, Di Santo SG, Cherubini A, Mossello E, Meagher D, Mazzone A, Bianchetti A, Ferrara N, Ferrari A, Musicco M, Trabucchi M, Bellelli G; ISGoD Group. Clinical Features Associated with Delirium Motor Subtypes in Older Inpatients: Results of a Multicenter Study. Am J Geriatr Psychiatry. 2017; 25:1064-1071.

Baird L, Spiller JA. A quality improvement approach to cognitive assessment on hospice admission: could we use the 4AT or Short CAM? BMJ Open Qual. 2017; 6(2):e000153

Bellelli G, Morandi A, Di Santo SG, Mazzone A, Cherubini A, Mossello E, Bo M, Bianchetti A, Rozzini R, Zanetti E, Musicco M, Ferrari A, Ferrara N, Trabucchi M; Italian Study Group on Delirium (ISGoD). "Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool. BMC Med. 2016; 14:106

Morandi A, Han JH, Meagher D, Vasilevskis E, Cerejeira J, Hasemann W, MacLullich AM, Annoni G, Trabucchi M, Bellelli G. Detecting Delirium Superimposed on Dementia: Evaluation of the Diagnostic Performance of the Richmond Agitation and Sedation Scale. J Am Med Dir Assoc. 2016; 17:828-33

selected LITERATURE relevant to the 4AT

GENERAL

Rieck KM, Pagali S, Miller DM. Delirium in hospitalized older adults. Hosp Pract. 2020 Mar;48(sup1):3-16

Davis D, Searle SD, Tsui A. The Scottish Intercollegiate Guidelines Network: risk reduction and management of delirium. Age Ageing. 2019;48:485-488

Bearn A, Lea W, Kusznir J. Improving the identification of patients with delirium using the 4AT assessment. Nurs Older People. 2018;30:18-27

Oliver D. Delirium matters. BMJ. 2016;353:i2886

De J, Wand AP. Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients. Gerontologist. 2015; 55:1079-99

Shenkin SD, Russ TC, Ryan TM, MacLullich AM. Screening for dementia and other causes of cognitive impairment in general hospital in-patients. Age Ageing. 2014; 43:166-8

Level of alertness/arousal component

Tieges Z, Quinn T, MacKenzie L, Davis D, Muniz-Terrera G, MacLullich AMJ, Shenkin SD. Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis. BMC Geriatr. 2021 Mar 5;21(1):162.

Richardson SJ, Davis DHJ, Bellelli G, Hasemann W, Meagher D, Kreisel SH, MacLullich AMJ, Cerejeira J, Morandi A. Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure. Int Psychogeriatr. 2017; 29:1585-1593

Han JH, Brummel NE, Chandrasekhar R, Wilson JE, Liu X, Vasilevskis EE, Girard TD, Carlo ME, Dittus RS, Schnelle JF, Ely EW. Exploring Delirium's Heterogeneity: Association Between Arousal Subtypes at Initial Presentation and 6-Month Mortality in Older Emergency Department Patients. Am J Geriatr Psychiatry. 2017; 25:233-242

Grossmann FF, Hasemann W, Kressig RW, Bingisser R, Nickel CH. Performance of the modified Richmond Agitation Sedation Scale in identifying delirium in older ED patients. Am J Emerg Med. 2017;35(9):1324-1326.

Rudolph JL. Arousal, Attention, and an Abundance of Opportunity to Advance Delirium Care. J Am Med Dir Assoc. 2016; 17:775-6

Morandi A, Han JH, Meagher D, et al. Detecting Delirium Superimposed on Dementia: Evaluation of the Diagnostic Performance of the Richmond Agitation and Sedation Scale. J Am Med Dir Assoc. 2016;17(9):828-833.

Bellelli G, Mazzone A, Morandi A, Latronico N, Perego S, Zazzetta S, Mazzola P, Annoni G. The Effect of an Impaired Arousal on Short- and Long-Term Mortality of Elderly Patients Admitted to an Acute Geriatric Unit. J Am Med Dir Assoc. 2016; 17:214-9

Han JH, Vasilevskis EE, Schnelle JF, et al. The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients. Acad Emerg Med. 2015;22(7):878-882.

Han JH, Vasilevskis EE, Shintani A, Graves AJ, Schnelle JF, Dittus RS, Powers JS, Wilson A, Storrow AB, Ely EW. Impaired arousal at initial presentation predicts 6-month mortality: An analysis of 1084 acutely ill older patients. J Hosp Med. 2014; 9:772-8

Tieges Z, McGrath A, Hall RJ, MacLullich AM. Abnormal level of arousal as a predictor of delirium and inattention: an exploratory study. Am J Geriatr Psychiatry. 2013; 21:1244-53

Chester JG, Beth Harrington M, Rudolph JL; VA Delirium Working Group. Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. J Hosp Med. 2012; 7:450-3

AMT4 component

Lindsay WA, Moppett IK. Interchangeability of AMT4 and AMTS in a hip fracture population. Anaesthesia. 2019;74(11):1477-1478.

Carpenter CR, Banerjee J, Keyes D, et al. Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta-analysis. Acad Emerg Med. 2019;26(2):226-245.

Hendry K, Quinn TJ, Evans J, Scortichini V, Miller H, Burns J, Cunnington A, Stott DJ. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Age Ageing. 2016;45(6):832-837.

Schofield I, Stott DJ, Tolson D, McFadyen A, Monaghan J, Nelson D. Screening for cognitive impairment in older people attending accident and emergency using the 4-item Abbreviated Mental Test. Eur J Emerg Med. 2010; 17:340-2

Swain DG, Nightingale PG. Evaluation of a shortened version of the Abbreviated Mental Test in a series of elderly patients. Clin Rehabil. 1997; 11:243-8

Months Backwards component

Hasemann W, Duncan N, Clarke C, Nouzova E, Süßenbach LM, Keerie C, Assi V, Weir CJ, Evans J, Walsh T, Wilson E, Quasim T, Middleton D, Weir AJ, Barnett JH, Stott DJ, MacLullich AMJ, Tieges Z. Comparing performance on the Months of the Year Backwards test in hospitalised patients with delirium, dementia, and no cognitive impairment: an exploratory study. Eur Geriatr Med. 2021 Jun 22.

O'Regan NA, Maughan K, Liddy N, Fitzgerald J, Adamis D, Molloy DW, Meagher D, Timmons S. Five short screening tests in the detection of prevalent delirium: diagnostic accuracy and performance in different neurocognitive subgroups. Int J Geriatr Psychiatry. 2016 Dec 5. [Epub ahead of print]

Meagher J, Leonard M, Donoghue L, O'Regan N, Timmons S, Exton C, Cullen W, Dunne C, Adamis D, Maclullich A, Meagher D. Months backward test: A review of its use in clinical studies. World J Psychiatry. 2015; 5:305-14

O'Regan NA, Ryan DJ, Boland E, Connolly W, McGlade C, Leonard M, Clare J, Eustace JA, Meagher D, Timmons S. Attention! A good bedside test for delirium? J Neurol Neurosurg Psychiatry. 2014; 85:1122-31