TABLE 1.

A roadmap for advancing delirium research: Proposal from the NIDUS Scientific Think Tank

Domain	Priority areas	Description
Definition and measurement	Refining the construct of delirium	Consensus approaches to identify key domains and supporting features of delirium Widespread and consistent application of new operationalized definition
	Uniform measurement tools for delirium identification and severity	Small set of standardized, well‐validated instruments for delirium Short‐ and long‐forms for clinical and research application Consistent usage
	Reference standard for diagnosis of delirium	Consensus approach to develop common reference standard definition and assessment Robust diagnostic algorithm Consistent application
	Etiologic subtypes of delirium	Standardized approaches to identify underlying contributors to delirium Incorporate biomarkers Use subtyping to target treatment
	Core outcomes set for delirium studies	Specified outcomes for clinical trials and studies of delirium Tailored to specific clinical settings Consistent application
Pathophysiology	Laboratory animal models for delirium	Experimental induced delirium in vulnerable animal Meet construct validity (accepted precipitating factor) and face validity (manifests some delirium domains) Test hypothesized pathophysiologic mechanisms to identify targets for future treatment trials
	Biomarkers for delirium in humans	Standardized approaches for specimen collection, analyses, and reporting Novel biomarkers: fluid, neuroimaging, electrophysiologic Discovery may involve advanced approaches, including signal processing and machine learning
	International consortia and biobanks	Large‐scale data and specimen banks to facilitate systems biology, ‐omics (eg, proteomics, metabolomics), and machine learning studies Systematic collection of clinical, biomarker, electrophysiologic, neuroimaging data, along with harmonization of variables and approaches
Prevention and treatment	Multifactorial, sequential approaches	Novel approaches to prevention Multicomponent treatment bundle, including nonpharmacologic and pharmacologic interventions targeted to proven risk factors and pathophysiologic pathways Sequential treatment approaches, targeting multiple biologic targets on pathways
	Novel trial designs	Adaptive trial designs (eg, Bayesian, platform) that allow customization while trial ongoing to refine interventions and study subpopulation Pragmatic trials to evaluate system‐wide or large‐scale management strategies Registry‐based clinical trials to improve efficiency and reduce costs
Public health campaign	Educational and public health campaigns	Public education to increase awareness, improve research funding, and address ageism and the stigma of delirium and dementia Workforce development and training of health‐care professionals Larges‐cale implementation of effective approaches for prevention and management of delirium Follow Alzheimer's disease approach Define societal impact and economic costs of delirium Health policy efforts to advance delirium awareness, prevention and clinical care, and research