BACKGROUND: Determination of a patient's cognitive status by use of a valid and 
reliable screening instrument is of major importance as early recognition and 
accurate diagnosis of delirium is necessary for effective management. This study 
determined the reliability, validity and diagnostic value of the Flemish 
translation of the NEECHAM Confusion Scale.
METHODS: A sample of 54 elderly hip fracture patients with a mean age of 80.9 
years (SD = 7.85) were included. To test the psychometric properties of the 
NEECHAM Confusion Scale, performance on the NEECHAM was compared to the 
Confusion Assessment Method (CAM) and the Mini-Mental State Examination (MMSE), 
by using aggregated data based on 5 data collection measurement points (repeated 
measures). The CAM and MMSE served as gold standards.
RESULTS: The alpha coefficient for the total NEECHAM score was high (0.88). 
Principal components analysis yielded a two-component solution accounting for 
70.8% of the total variance. High correlations were found between the total 
NEECHAM scores and total MMSE (0.75) and total CAM severity scores (-0.73), 
respectively. Diagnostic values using the CAM algorithm as gold standard showed 
76.9% sensitivity, 64.6% specificity, 13.5% positive and 97.5% negative 
predictive values, respectively.
CONCLUSION: This validation of the Flemish version of the NEECHAM Confusion 
Scale adds to previous evidence suggesting that this scale holds promise as a 
valuable screening instrument for delirium in clinical practice. Further 
validation studies in diverse clinical populations; however, are needed.