The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. The study calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients ages greater than or equal to 65 (N = 259), 17 (7 percent) screened positive for suspicion of EA. The study identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94 percent (95 percent confidence interval (CI) 71-100 percent) and 90 percent (95 percent CI 85-93 percent), respectively. These results inform a proposed screening tool for multisite validation testing. (publisher abstract modified)
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