4AT – 2 minute delirium detection validated in 30+ studies

Evidence-based bedside tool for rapid delirium screening across acute, community, and peri-operative settings.

  • ~2 min administration time

  • No training required: designed for immediate use by nurses, doctors, and AHPs

  • Extensive evidence: 32 diagnostic‑accuracy studies (>6000 pts)

  • High sensitivity & specificity

  • Globally adopted: translated into >20 languages & included in national guidelines

  • Completely free: instant access, no registration required

  • Free EHR integration: ready for systems like EPIC with no licensing required

"Balancing the evidence for accuracy and cost effectiveness with the practicality of implementing the tests, the committee agreed that the 4AT was the best option for most settings.

It is among the most accurate of the tools reviewed, quick and simple to use, and has a broader range of evidence to support it."

- UK NICE Guideline on Delirium, 2023


Delirium (Acute Confusion): A Family Guide to Sudden Changes in Thinking and Memory

A detailed guide for families and carergivers - coming soon. By Professor Alasdair MacLullich (4AT author).


More details