What is the 4AT?
The 4AT or 4 ’A’s Test is a simple and short (<2 min) delirium detection tool purposely designed for easy clinical use. It does not require special training.
The 4AT is the most validated delirium tool, with 31 diagnostic test accuracy studies involving >6000 patients. It is highly sensitive and specific.
The 4AT is highly effective in clinical practice. Multiple studies prove that the 4AT is sensitive to delirium when used in routine care, and has good completion rates. It is one of the most-used delirium tools globally, and is recommended in multiple guidelines.
Further information
The 4AT is free, and always will be.
Do I need permission to use the 4AT? No permission is required to download and use. This includes use in Electronic Health Records (EHRs) / Electronic Medical Records (EMRs).
Do I need to register to use the 4AT? No registration of any kind is required. You are welcome to download from this website or any other source, and use freely.
Brief guide to clinical delirium care
Note: responsibility for the interpretation of scores and any actions rests with the clinical team using the 4AT. As per accepted clinical practice, a diagnosis of delirium should always be made following clinical assessment by suitably qualified staff.
Website by Alasdair MacLullich