On behalf of my coauthors I would like to thank Dr Reade for his comments and questions. He asks if nurses were able to make subjective delirium assessments on patients who had RASS scores of −4 and −5 and were thus rated as “unable to assess” by the CAM-ICU raters. The answer is that it was left to the nurses’ discretion not to rate patients if they were comatose. No patients who had RASS scores of −4 or −5 were subjectively rated by the nurses.

Reade points out a sentence in our abstract regarding the use of objective criteria with the CAM-ICU allowing “detection of delirium in more patients,”(pe12) that we could have more clearly stated as follows: “While the overall delirium incidence found with the CAM-ICU was lower than subjectively rated, objective criteria helped detect delirium in a significant number...

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