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Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods
Tammy T. Hshieh, Benjamin Albert Chapin, W Mak, Guoquan Xu, Eva M. Schmitt, Edward R. Marcantonio, Hannah Shanes, Cole Heine et al.. Journal of Geriatric Psychiatry and Neurology, 2025-05-16
Topic: Risk, prevention and care in population studies
PurposeDelirium is a common yet preventable complication of hospitalization, surgery and illness that is associated with poor outcomes. Older adults with Alzheimer's Disease and Related Dementias (ADRD) are especially vulnerable to delirium and experience greater delirium severity, yet no existing assessment tool is specifically designed to evaluate this vulnerable population. This study will validate two new delirium severity instruments, the Delirium Severity (DEL-S) rating for all older adults and the Delirium Severity Rating in ADRD (DEL-S-AD) for patients with dementia.Design/Setting and ParticipantsThe Better ASsessment of ILlness II (BASIL II) study is an innovative prospective cohort study that measures cognitive function, delirium, delirium severity, demographics, clinical and functional variables and clinical outcomes. Participants include older adults from 3 unique yet complementary clinical sites: medical inpatients, elective surgery inpatients, or skilled nursing facility residents.MethodsPerformance of DEL-S and DEL-S-AD items in older adults with cognition ranging from no impairment to moderate impairment will be determined. Analyses will include psychometric characteristics of DEL-S and DEL-S-AD items, harmonization of the two scales and validation against reference standard diagnoses.Conclusions and ImplicationsResults from this study will help accurately measure delirium severity, a critically important, graded outcome. The DEL-S-AD instrument holds broad applications in persons with and without ADRD to monitor delirium severity in clinical settings, and as an outcome measure in future clinical treatment trials and pathophysiologic studies. Ultimately, the DEL-S and DEL-S-AD have the potential to improve health care for the vulnerable, growing population of older adults with cognitive impairment worldwide.
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APA 7th
Hshieh, T. T., Chapin, B. A., Mak, W., Xu, G., Schmitt, E. M., Marcantonio, E. R., et al. (2025). Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods. Journal of Geriatric Psychiatry and Neurology. https://doi.org/10.1177/08919887251343604
Vancouver
Hshieh TT, Chapin BA, Mak W, Xu G, Schmitt EM, Marcantonio ER, et al. Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods. Journal of Geriatric Psychiatry and Neurology. 2025. doi:10.1177/08919887251343604. PMID: 40380784.
BibTeX
@article{hshieh2025-40380784,
author = {Hshieh, Tammy T. and Chapin, Benjamin Albert and Mak, W and Xu, Guoquan and Schmitt, Eva M. and Marcantonio, Edward R. and Shanes, Hannah and Heine, Cole and others},
title = {{Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods}},
journal = {Journal of Geriatric Psychiatry and Neurology},
year = {2025},
doi = {10.1177/08919887251343604},
pmid = {40380784},
url = {https://doi.org/10.1177/08919887251343604}
}
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Key findings
- PurposeDelirium is a common yet preventable complication of hospitalization, surgery and illness that is associated with poor outcomes.
Why it matters
This paper describes the planned BASIL II study, which will validate two new delirium severity instruments, including one for patients with dementia. No results are reported yet, so it provides no evidence about treating, curing, or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 46/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 44 of the 96 points we could judge it on, which is 46 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Geriatric Psychiatry and Neurology) |
| Journal's citation record | 1 / 4 | Journal of Geriatric Psychiatry and Neurology: journal h-index 105 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 15 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40380784) |
| Free to read | 2 / 2 | Free to read |
| Points | 44 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 44 of the 96 points we could judge it on is 46 out of 100. |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
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