# Development and Assessment of Diagnostic Accuracy of a Telemedicine-Based Delirium Assessment Tool (The Tele-CAM)

> **NIH NIH R21** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $197,588

## Abstract

PROJECT SUMMARY
The overarching objective of this project is to develop and establish the diagnostic accuracy of a telemedicine-
based delirium assessment tool, the TELE-CAM.
Delirium, an acute change in cognition and attention is associated with a variety of undesirable outcomes
including increased in-hospital mortality, long-term cognitive decline that mimics dementia, and increased risk
for institutionalization. Delirium is prevalent in the post-operative population, and prevalence increases with
age. Recent work performed by Dr. Austin and his research team demonstrated that many subjects were
discharged home with active delirium. Patients discharged with active delirium to a nursing facility have worse
outcomes than non-delirious patients. Despite the known negative effects of delirium in the post-acute care
institution population, little is known about the impact of persistent delirium on functional recovery after
discharge to the home setting. Current clinical diagnosis of delirium requires a face-to-face encounter, which
limits the ability to feasibly perform frequent delirium assessments in the post-discharge setting.
Over the past few years, devices that support videoconferencing, such as smart phones, have become
commonplace. Concurrently, interest in telemedicine and remote diagnoses of cognitive disorders has grown.
This interest has become even more acute due to the ongoing COVID-19 pandemic. We hypothesize that
currently available videoconferencing capabilities can be easily and quickly utilized to perform reliable delirium
assessments in older adults in the home setting. This project will refine and assess the diagnostic accuracy of
a telemedicine-based delirium assessment tool based on the CAM (the TELE-CAM) that can be utilized in the
home setting and assessed by remote researchers.
We propose a prospective cohort study that will develop and refine this tool as well as demonstrate the
feasibility of conducting in-home delirium assessments (Aim 1). We will also establish the diagnostic accuracy
of our remote delirium assessment tool compared to a reference standard face-to-face assessment (Aim 2).
We will enroll 400 older participants either hospitalized for an acute medical problem or major surgery for this
project. The ability to perform in-home delirium assessments will prove invaluable to researchers investigating
the appropriateness of discharging actively delirious patients’ home versus keeping them in the hospital until
resolution of their delirium. Further, it will provide a method for clinicians to perform quick, remote delirium
assessments of their patients.

## Key facts

- **NIH application ID:** 10772014
- **Project number:** 5R21AG080331-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Charles Adrian Austin
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $197,588
- **Award type:** 5
- **Project period:** 2023-02-01 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10772014

## Citation

> US National Institutes of Health, RePORTER application 10772014, Development and Assessment of Diagnostic Accuracy of a Telemedicine-Based Delirium Assessment Tool (The Tele-CAM) (5R21AG080331-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10772014. Licensed CC0.

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