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The 4 'A's test detects delirium in acutely ill patients with a sensitivity of 76% and a specificity of 95%.

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Alasdair MJ MacLullich 1,*, Susan D Shenkin 1, Steve Goodacre 2, Mary Godfrey 3, Janet Hanley 4, Antaine Stíobhairt 1, Elizabeth Lavender 3, Julia Boyd 5, Jacqueline Stephen 5,6, Christopher Weir 5,6, Allan MacRaild 7, Jill Steven 7, Polly Black 7, Katharina Diernberger 6,7, Peter Hall 5, Zoë Tieges 1, Christopher Fox 8, Atul Anand 1, John Young 9, Najma Siddiqi 10,11,12, Alasdair Gray 6,7

1 Geriatric Medicine, Division of Health Sciences, University of Edinburgh, Edinburgh, UK
2 Emergency Medicine, University of Sheffield, Sheffield, UK
3 Health and Social Care, Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
4 School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
5 Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
6 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
7 Emergency Medicine Research Group (EMERGE), NHS Lothian, Edinburgh, UK
8 Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
9 Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
10 Psychiatry, University of York, York,
11 Hull York Medical School, York, UK
12 Bradford District Care NHS Foundation Trust, Bradford, UK
* Corresponding author Email:

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