Some studies have shown a high sensitivity when such assessments are performed by bedside nurses,42 whereas other studies have shown conflicting results.43 Used alone (without an accompanying sedation scale), none of the published scales distinguish hyperactive from hypoactive delirium, and none of the published scales quantify the relative importance of individual elements of the scales despite recognition that specific treatments may shorten the duration of some elements and prolong the duration of others. All the scales dichotomize delirium as being either present or absent, although it would seem to be intuitive that delirium has different degrees of severity. The CAM-ICU and ICDSC are currently the two accepted methods for identifying a condition that otherwise frequently goes undiagnosed.44