The 4 'A's Test <unk>  is a bedside medical scale used to help determine if a person has positive signs for delirium. The<unk>  also includes cognitive test items, making it suitable also for use as a rapid test for cognitive impairment. The<unk>  is designed to be used as a delirium detection tool in general clinical settings, inpatient hospital settings outside of the Intensive Care Unit (ICU), or in the community. The<unk>  is intended to be used by healthcare practitioners without the need for special training, and it takes around two minutes to complete. The test was first published online in 2011; the<unk>  website provides downloads, and a guide to the test along with case examples. The<unk>  is also available on the Android and iOS platforms, and as an online calculator. The<unk>  has the most published diagnostic test accuracy data of any delirium tool, with 24 published studies involving >5000 observations. It has been evaluated in multiple areas of practice including in the emergency department (ED), medical, surgical and community settings. The<unk>  is used internationally in both clinical practice and research. It has been included in clinical guidelines and policy documents. Some evidence shows that the<unk>  can be implemented at scale in real-world clinical practice and that it shows positive score rates at comparable levels to the expected delirium prevalence rates. A major 2022 two-centre study in real-world clinical populations (total N=82,770) found that<unk>  positive scores were aligned with expected delirium rates, and also were strongly linked with important outcomes including 30-day mortality, one-year mortality, hospital length of stay, and days at home in the year following hospital admission. Notably, the<unk>  was completed as part of usual care by a large number of different staff (mostly doctors and nurses) who had not received special training in use of the<unk> . This study therefore showed that the<unk>  is feasible in large-scale practice and that it provides real-time delirium ascertainment with positive scores being linked to important short and longer-term outcomes.
4AT
TGBA01AD
F1000 
D50 
HPTN 052
ALD-52
GUCH
HPD