Ahmed Hakami
Delirium severity is one of seven outcomes in the Del-CorS core outcome set for trials of interventions to prevent or treat delirium in critically ill adults, yet the ICU intervention literature has been characterised predominantly through delirium occurrence. How severity is measured, scored, summarised and reported when used as an outcome has not been mapped. Instruments do not divide cleanly into detection and severity tools, and the same instrument can function as an occurrence measure or a severity measure depending on whether it is scored as a threshold or as a gradient. This scoping review maps measurement and reporting practice across primary studies evaluating interventions intended to prevent, reduce, manage or treat delirium in adult ICU populations. Conducted according to JBI scoping review methodology and reported using PRISMA-ScR, it addresses which instruments are used and how they are scored, how assessment is operationalised in frequency and window, what summary metrics and effect measures are reported, what terminology authors use for the construct, and whether severity was designated a primary or secondary outcome. The search is structured on the PCC framework and combines three domains: Population (adults admitted to intensive or critical care), Concept (measurement and reporting of delirium severity as an outcome), and Context (primary intervention studies intended to prevent, reduce, manage or treat delirium), combined as 1 AND 2 AND 3. Searches will be run in MEDLINE (Ovid), PubMed, Embase, CINAHL Ultimate, APA PsycINFO and Web of Science Core Collection. Screening and charting will be performed independently in duplicate. Consistent with JBI guidance, critical appraisal of individual sources will not be undertaken, as the objective is to map practice rather than grade evidence. Findings are intended to inform the design of future ICU delirium trials and to support core-outcome-set implementation.