Test Instrument Research Articles

Accuracy of the Bedside Examination in Patients with suspected Acute Unilateral Peripheral Vestibulopathy.

Acute unilateral peripheral vestibulopathy (AUPVP) is a frequent form of peripheral vestibular vertigo characterized by unilateral vestibular organ dysfunction. Diagnostic challenges in anamnesis and bedside examination can lead to potential misdiagnoses. This study investigated the sensitivity of bedside examinations in diagnosing AUPVP. This retrospective analysis examined 136 AUPVP inpatients at a level 3 university hospital between 2017 and 2019. Demographic data and bedside test results were collected. Instrumental otoneurological tests included caloric testing and video head impulse test (HIT). The sensitivity of each bedside parameter was computed based on the instrumental diagnostics, and statistical analyses were performed. The study included 76 men and 60 women, with a mean age of 59.2 years. Spontaneous nystagmus exhibited a sensitivity of 92%, whereas the absence of skew deviation was identified with a sensitivity of 98%. Abnormal bedside HIT showed a sensitivity of 87%. The combined HINTS (HIT, nystagmus, and test of skew) had a sensitivity of 83%. The Romberg test and Fukuda test demonstrated sensitivities of 26% and 48%, respectively. The sensitivity of bedside tests varied from 26% to 98%. This aligns with previous literature, highlighting the challenge of differentiating AUPVP from vestibular pseudoneuritis solely through bedside examination. Although the tests excel in excluding central causes, they are insufficient for diagnosing AUPVP with certainty. In addition, the bedside examination sensitivities vary widely, and early radiological imaging can be misleading. Therefore, this study underlines the necessity of prompt otoneurological testing for accurate exclusion of vestibular pseudoneuritis and thus improve patient outcomes.

The Effect of Brand Image, Product Quality, and Price on Thriftshop Clothing Purchasing Decisions in Medan City (Case Study @cchase.id)

Secondhand clothing, especially among teens, has become more fashionable because most people consider it unique and classic. Indonesia sold more imported used garments due to their higher quality and lower price. Demand for imported used clothes is rising. Fans and customers can buy affordable, wearable famous brand outfits. This study examines how brand image, quality, and price affect buying decisions. This quantitative study collects data using a questionnaire and analyzes it using IBM SPSS Software. Probability and puposive sampling were utilized in this investigation. Research instrument tests, classical assumption tests, model accuracy tests, multiple linear analysis, and partial tests are used in data analysis. Brand image, product quality, and price influence Medan City Thriftshop clothes purchases, according to Hasi research. Brand image strongly influences used apparel purchases. Brand image t test has 0.000 0.05 significant level and 3.904> 1.655 tcount> ttable value. Product quality strongly influences used clothing purchases. The t-test results for product quality indicate a significance level of 0.000 <0.05 and a tcount> ttable value of 1.747> 1.655. Price strongly influences used clothing purchases. The t-test results for the price variable indicate a significance level of 0.000 < 0.05 and a tcount value of 3.753> 1.655 Thus, brand image, quality, and pricing influence purchases

Effectiveness of Higher Order Thinking Skills-based Test Instruments in Science Learning in Indonesia: A Meta-analysis

This research is motivated by the many applications of Higher Order Thinking Skills-based test instruments in science learning. However, it has not been found how effective the instrument is in science learning. The purpose of this study was to determine the effectiveness of Higher Order Thinking Skills-based test instruments in science learning. This type of research is a meta-analysis. Data sources come from the databases of Google Scholar, Hindawi, ScienceDirect, Wiley, Taylor of Francis, Sage Journal, Springer, ProQuest and ERIC. Search keywords are test instruments, test instruments based on Higher Order Thinking Skills in science learning, and higher order thinking skills. This study analyzed 20 articles published in 2020-2023 used in the meta-analysis. Data analysis techniques with the help of JSAP software. The results concluded that the summary effect size value was 1.24 (very high effect size). This finding shows that the use of test instruments based on Higher Order Thinking Skills is effectively applied in science learning. Furthermore, the research provides higher order tinking skills-based test instruments in science learning in Indonesia and provides important information for the application of higher order thinking skills-based test instruments in the future

Efektivitas Media Pembelajaran Berbasis Augmented Reality Untuk Meningkatkan Keterampilan Berpikir Kritis pada Materi IPAS

Technology in the 5.0 revolution is developing very rapidly so it is necessary to prepare the student to face the challenges of the 21st century by having 21st century skills, namely critical thinking Having a low category of critical thinking because the teacher in using the media has not facilitated students to think critically tends to be monotonous and boring. The purpose of this experiment is to establish the effective of AR media to improving learners' critical thinking skills on IPAS material. The study used quantitative research methods with the research type true experiment with pretest-posttest control group design. The data collection methods used are test instrument. The results of the study were tested Independent T-Test to find out the enhancing students' critical thinking skills then conducted an effectiveness test to determine the effectiveness of the application of Augmented Reality-based learning media to improve critical thinking skills on IPAS material. The research results of the average value of the experimental class using AR media are 58.92 and 75.98 while the average value of the control class using conventional media is 58.80 and 63.56. The test results of the Independent Sample T-Test obtained with a value of 0.000 with the provisions of the test decision if significant less than 0.05 then there is sig. effects among the experimental and control posttests. The effective test using N-Gain obtained a result of 56.52 which was categorized as sufficient. It is synthesized that AR-based learning media improves critical thinking skills and the effectiveness of AR-based learning media is effective to use with the N-Gain test.

Arthroscopic and open reconstruction of the posterolateral corner of the knee have equally good clinical results: first results of a prospective 12-month follow-up study.

Arthroscopic reconstruction techniques for higher-grade posterolateral corner (PLC) injuries (Fanelli Type B, PoLIS LI-B) have not yet been validated in clinical studies. The open reconstruction technique described by Arciero is well-established and showed good restoration of joint stability in previous studies. This study aimed to compare clinical outcomes of this established open surgery technique to a newly developed arthroscopic technique in a prospective randomized clinical trial. Between 2019 and 2021, this study focused on chronic high-grade PLC injuries (Fanelli Type B, PoLIS LI-B). Group A consisted of patients treated with conventional open surgery following Arciero's technique, while Group B included patients treated with Arciero's arthroscopic technique. All cases underwent additional PCL reconstruction. After a minimum 12-month follow-up, clinical scores and objective stability assessments were compared between the groups. In total, 26 (group A 12, group B 14) eligible patients with a mean follow-up of 14.9 ± 7.2 months were evaluated in the present study. Knee stability and patient-reported outcome scores (PROMS) were significantly improved when comparing pre- and post-operative values (p < 0.0001). No clinically relevant differences in PROMS (Lysholm: A 83.9 ± 11.4 vs. B 85.3 ± 13.8; IKDC: A 76.91 ± 12.6 vs. B 76.8 ± 15.7) were shown in both groups. Additionally, no statistically significant differences were detected between groups with respect to external rotation, range of motion and instrumental stability testing. Arthroscopic reconstruction showed significantly shorter operation time (p = 0.0109). There were no clinical failures or neurovascular complications of the surgical procedures. Both surgical techniques for isolated chronic PLC Fanelli Type B injuries significantly improved the knee stability, were equivalent with respect to PROMs and led to good clinical results. However, arthroscopic PLC reconstruction was associated with a shorter surgery time compared to open PLC reconstruction. Therefore, arthroscopic PLC reconstruction may be a viable option in the hands of an experienced surgeon. Prospective cohort study, II.

Elevating Problem-Solving Prowess: The Impact of ICT-Assisted ReCODE Learning Model on Class VIII Students' Problem-Solving Skills at SMPN 18 Makassar

Problem-solving skills are one of the 21st-century skills that are important to improve, especially in the field of science. However, some studies show that students' problem-solving skills are still low. This study aims to determine the effect of the ICT-assisted Reading, Connecting, Observing, Discussing, Evaluating (ReCODE) learning model on students' problem-solving skills. This research is a quasi-experimental research with Pretest-Posttest Nonequivalent Control Group Design research design. The study population was all students of class VIII SMPN 18 Makassar. Sampling using a purposive sampling technique which consisted of experimental class and control class. The instrument used was an essay test instrument with data collection methods using pre-test and post-test results. Data were analyzed using descriptive and inferential statistical analysis. The results of the analysis were obtained tcount = 2.4 &gt; ttable = 1.67 which means H0 is rejected and H1 is accepted. Based on these results, it can be concluded that the ReCODE Learning model assisted by ICT affects the problem-solving skills of class VIII students of SMPN 18 Makassar.

The Effect of Ethnoscience Learning on the Development of Students' Cognitive and Affective Aspects in Junior High School

This research aims to examine the influence of ethnoscience learning on the development of students' cognitive and affective aspects. This quasi-experimental research uses a pre-test post-test non-equivalent control group design. This research was carried out in the odd semester of the 2022/2023 academic year. The population of this study was 320 class VII students at MTsN 1 Mataram, with a sample size of 34 people in the experimental class and 34 people in the control class. Data was obtained from test instruments for the "cognitive" aspect in the form of essays and questionnaire instruments for the "affective" aspect in the form of attitude statements. The statistical test used in this research is one-way MANCOVA with one covariate. The results of the research show that there is a significant difference in the influence of using ethnoscience learning on cognitive and affective learning simultaneously or together after controlling for students' initial abilities. The cognitive and affective scores of students in classes that use ethnoscience learning are higher than those in conventional classes. The conclusion of this research is that ethnoscience learning has a positive effect on the cognitive and affective aspects of junior high school students at MTsN 1 Mataram.

A Predictive Model for Wellbore Temperature in High-Sulfur Gas Wells Incorporating Sulfur Deposition

HSG (high-sulfur gas) reservoirs are prevalent globally, yet their exploitation is hindered by elevated levels of hydrogen sulfide. A decrease in temperature and pressure may result in the formation of sulfur deposits, thereby exerting a notable influence on gas production. Test instruments are susceptible to significant corrosion due to the presence of hydrogen sulfide, resulting in challenges in obtaining bottom hole temperature and pressure test data. Consequently, a WTD (wellbore temperature distribution) model incorporating sulfur precipitation was developed based on PPP (physical property parameter), heat transfer, and GSTP (gas–solid two-phase) flow models. The comparison of a 2.53% temperature error and a 4.80% pressure error with actual field test data indicates that the established model exhibits high accuracy. An analysis is conducted on the impact of various factors, such as production, sulfur layer thickness, reservoir temperature, and reservoir pressure, on the distribution of the wellbore temperature field and pressure field. Increased gas production leads to higher wellhead temperatures. The presence of sulfur deposits reduces the flow area and wellhead pressure. A 40% concentration of hydrogen sulfide results in a 2 MPa pressure drop compared to a 20% concentration. Decreased reservoir pressure and temperature facilitate the formation of sulfur deposits at the wellhead.

Optimal Instrument Selection Using Bayesian Model Averaging for Model Implied Instrumental Variable Two Stage Least Squares Estimators

Model-Implied Instrumental Variable Two-Stage Least Squares (MIIV-2SLS) is a limited information, equation-by-equation, noniterative estimator for latent variable models. Associated with this estimator are equation-specific tests of model misspecification. One issue with equation-specific tests is that they lack specificity, in that they indicate that some instruments are problematic without revealing which specific ones. Instruments that are poor predictors of their target variables (“weak instruments”) is a second potential problem. We propose a novel extension to detect instrument-specific tests of misspecification and weak instruments. We term this the Model-Implied Instrumental Variable Two-Stage Bayesian Model Averaging (MIIV-2SBMA) estimator. We evaluate the performance of MIIV-2SBMA against MIIV-2SLS in a simulation study and show that it has comparable performance in terms of parameter estimation. Additionally, our instrument-specific overidentification tests developed within the MIIV-2SBMA framework show increased power to detect specific problematic and weak instruments. Finally, we demonstrate MIIV-2SBMA using an empirical example.

Contextual Teaching and Learning-based E-Worksheet on Science Subjects for Fourth Grade Elementary Schools

Lack of motivation to learn students results in them being less focused on learning and less active during the learning process, which impacts low student learning outcomes, especially in the science and science learning process. A lack of innovative teaching materials mostly causes this or tends to be monotonous. Therefore, supportive teaching materials that are attractive in form and based on appropriate learning models are needed so that students are enthusiastic about learning and can think critically. One medium that is a solution is to use CTL-based E-Worksheet. This research aims to develop a CTL-based E-Worksheet for grade 4 elementary school science content. This research is a development research type with the ADDIE model. The research subject is CTL-based E-Worksheet media on class 4 science content. Data collection uses expert test instruments and trials. The data analysis technique calculates the percentage score for validation assessments and user responses. The research results show that the development of a CTL-based E-Worksheet for grade 4 science content meets very valid criteria from the quality aspect, with a detailed score of 93.775% from media experts, 95% from learning design experts, and 94.6% from learning content experts. The results of the student response test showed an increase from the pretest results, with an average score of 34.8%, to an average score of 84.8 on the students' post-test results. Based on these results, the CTL-based E-Worksheet teaching materials that have been developed are suitable for application in learning. This research implies that it presents CTL-based E-Worksheet learning media with grade 4 science content as a solution to problems in the student learning process.

Cross-regional integration of renewable energy and corporate carbon emissions: Evidence from China's cross-regional surplus renewable energy spot trading pilot

Using data from A-share listed renewable energy enterprises, this study constructs a quasi-natural experiment with China's Cross-regional Surplus Renewable Energy Spot Trading Pilot policies as the shock and explores its impact on corporate carbon emissions from 2014 to 2021 using the staggered difference-in-differences (DID) model. The results indicate that the Cross-regional Surplus Renewable Energy Spot Trading Pilot can significantly reduce the carbon emissions of renewable energy enterprises in pilot regions during the sample period, demonstrating heterogeneity in regional location, ownership, and corporate social responsibility. The positive effect of the pilot is more pronounced for enterprises in the central region, state-owned enterprises, and enterprises with a high sense of social responsibility. The results remained robust when we applied propensity score matching DID, difference-in-differences-in-differences (DDD), placebo tests, alternative measures and 2SLS instrumental variable tests to further eliminate the interference from other factors. Moreover, in terms of mechanisms, the Cross-regional Surplus Renewable Energy Spot Trading Pilot can reduce corporate carbon emissions by promoting renewable energy consumption and corporate energy efficiency. This study enhances understanding of cross-regional renewable energy integration, expanding discussions on selecting trajectories for energy efficiency and emissions reduction goals in the energy sector. Our findings offer practical examples of how different regions and countries promote the integration of renewable energy markets, thereby contributing to research on renewable energy integration.

The extended finite element method in endodontics: A scoping review and future directions for cyclic fatigue testing of nickel-titanium instruments.

The present study reviews the current literature regarding the utilization of the extended finite element method (XFEM) in clinical and experimental endodontic studies and the suitability of XFEM in the assessment of cyclic fatigue in rotary endodontic nickel-titanium (NiTi) instruments. An electronic literature search was conducted using the appropriate search terms, and the titles and abstracts were screened for relevance. The search yielded 13 hits after duplicates were removed, and four studies met the inclusion criteria for review. No studies to date have utilized XFEM to study cyclic fatigue or crack propagation in rotary endodontic NiTi instruments. Challenges such as modelling material inputs and fatigue criteria could explain the lack of utilization of XFEM in the analysis of mechanical behavior in NiTi instruments. The review showed that XFEM was seldom employed in endodontic literature. Recent work suggests potential promise in using XFEM for modelling NiTi structures.

Selected properties of X120Mn12 steel welded joints by means of the plasma-MAG hybrid method

The article describes properties of welds made of high wear resistance X120Mn12 steel obtained by the hybrid PTA-MAG (plasma transferred arc – metal active gas) method. The specimens were 8 mm thick rectangular (200 mm × 350 mm) sheets metal. The analyzed butt welds were made with the parameters selected according to the criterion of smallest cross-sectional area of welds and the narrowest HAZ (heat affected zone). The outcome of metallographic tests of weld, HAZ and parent material, hardness distribution and XRD (X-ray diffraction) patterns of selected areas are presented. The IIT (Instrumented Indentation Test) method was used to describe the distribution of mechanical properties shaped by thermal cycle annealing of the welding process. The investigation shows that the application of the PTA-MAG hybrid heat source for welding manganese steel enables the use of the filler material ER307 (AWS-A5.9). The hybrid PTA-MAG welding system has the relatively high potential to be an efficient alternative to welding standard processes for X120Mn12 steel due to the HAZ overheating limitation. The zone of high-risk weld cracking is the part of the HAZ close to the fusion area that has been reheated during weldment formation. Heat input about 0.6 kJ/mm is needed to provide full deep penetration butt weld without defects and with a vapor capillary of wide enough to cover the weld gap. The increase of hardness in the welded joint is smooth distributed and going up to 10% compared to the base material. The width of HAZ was &lt;1 mm. Intensive carbides precipitation in HAZ has been avoided successfully.

Experiences of experts in intelligence measurement of South African school learners

This qualitative research study emerged from the essential need for reliable and valid intelligence test instruments for South African school learners, who are characterised as a diverse population with their variety in culture, ethnicity, and language, as well as having unequal socio-economic and educational backgrounds. The aim of this research study was to use a qualitative interpretive description research design to explore and describe the experiences of both experts in intelligence test development and/or adaptation as well as psychologists and psychometrists who have administered intelligence tests to South African school learners in various contexts. Twelve psychologists and/or psychometrists were interviewed, of which six were also experts in test development and/or adaptation, which yielded four themes after thematic analysis, namely, utilised intelligence measurements in the current South African school learner context are less relevant; the South African education system is a major issue specifically within lower socio-economic status (SES) contexts; it does not seem feasible to design or adapt suitable intelligence measures that are valid and reliable in the current South African school learner context; and key informants’ recommendations from their experiences.Contribution: This research study contributes to the understanding of the measurement of intelligence of South African school learners in diverse contexts. Findings of this research study can guide the strategic process to design an intelligence instrument suitable for a South African population of school learners, informing fair assessment practices for multiethnic equalisation.

Science Fun Learning for the Students Affected of Natural Disasters

Fun learning will attract students to classroom learning activities learning, especially for victims of natural disasters. Students who experience natural disasters fear doing various things at home and outside the home (school). This study aims to find out whether fun science learning carried out by planting plants can improve students' understanding of learning science. This quantitative descriptive research uses test instruments to measure students' knowledge of family medicinal plant material. The population in this study was elementary school students who were victims of the earthquake natural disaster earthquake in 2022, while the research sample was 15 elementary school students. This sampling is done randomly. The data obtained were analyzed descriptively to determine improved student understanding of learning science. The results of data analysis showed that science fun learning applied through outdoor learning activities by planting family medicinal plants can increase students' understanding related to science material. However, the improvement is categorized as low based on the N-gain score 0.2. The recommendation of this study is to improve student understanding of when fun science learning should be supplemented with other methods by referring to the local wisdom of participants. Thus, the feeling of trauma that saddens the survivors will be slightly forgotten with fun activities and education.

Assessment of residual prestress in existing concrete bridges: The Kalix bridge

The direct socio-economic consequences of the deterioration of aging infrastructure systems have triggered a continuous process of revising and updating current design standards and guidelines for critical network components. Specifically, long-term degradation processes demand the analysis and evaluation of vital structural assets such as prestressed concrete bridges. It is crucial to develop theoretically consistent, user-friendly, and non-destructive methodologies that engineering professionals can employ to prevent and mitigate potential catastrophic outcomes during the service life of these bridges. This study provides a thorough review of the available testing methods employed over the years for prestressed concrete bridges and introduces a comprehensive framework for evaluating existing methods for residual prestress force assessment. Through a multi-criteria selection process, the three most feasible tests were designed and carried out on an existing 66-year-old balanced cantilever box girder bridge exposed to freezing temperatures that affected the instrumentation plan and test execution. Finally, predictive models compliant with standard codes were calibrated based on the experimental results and the life cycle loss of prestress forces was evaluated to assess relevant bounding intervals. Findings reveal limited on-site testing and discrepancies between calculated residual forces and predictions by standard codes. The saw cut method showed a 18% difference from the initial applied prestress according to the prestress protocol, suggesting the use of a cover meter and concrete modulus evaluation for improved accuracy. The strand cutting method resulted in a 14% difference, emphasizing the need for stress redistribution assessment. The second-order deflection method showed a 6% difference, indicating a focus on enhanced boundary conditions and thorough sensitivity analysis for future investigations.

The Effect of Remuneration and Work Motivation on the Performance of Administrative Employees

This study aims to determine and analyze the effect of Remuneration and Work Motivation on the Performance of Administrative Employees at RSUP Prof. Dr. R. D. Kandou. This study used a quantitative approach. The population in this study was administrative employees at RSUP Prof. Dr. R. D. Kandou. The sampling technique uses a simple random sampling technique. Data collection techniques by distributing questionnaires, while secondary data through literature studies by reading various literature. Data analysis techniques use Research Instrument Test (validity and reliability test), t test, F test, r square test and multiple linear regression analysis with the help of SPSS software. The results of this study show that: (1) Remuneration has a positive and significant effect on performance; (2) Work Motivation has a positive and significant effect on Performance; (3) Remuneration and Work Motivation have a positive and significant effect on Performance. The performance of administrative employees at RSUP Prof. Dr. R. D. Kandou is influenced by remuneration of 41.4% and work motivation of 31.4%. It is partially concluded that the variable of Work Motivation most dominantly affects the Performance of Administrative Employees. Suggestions that can be conveyed to RSUP Prof. Dr. R. D. Kandou that it is necessary to continue to monitor and evaluate employee performance so that the services provided to the community are maximized. Moreover, motivation at work is one of the factors that can improve the performance of administrative employees at RSUP Prof. Dr. R. D. Kandou.

INTEREST IN INVESTING IN MUTUAL FUNDS USING FINTECH APPLICATIONS: DETERMINANTS AND IMPACT ON MUTUAL FUND PURCHASE DECISIONS

The aim of this research was to analyze interest in investing in mutual funds using an applicationfintech: determinants and their impact on mutual fund purchasing decisions as well as to test the influence of motivation and knowledge on interest in investing in mutual funds and their impact on mutual fund purchasing decisions as well as finding out the most dominant variables. The population in this study were respondents who used the applicationfintech mutual funds. Samples are determined by techniquePurposive Sampling, with 130 respondents. The data collection technique used was a questionnaire. The analysis techniques used in this research are instrument testing (validity test and reliability test), classical assumption test, descriptive statistical analysis, factor analysis, hypothesis testing and coefficient of determination using the SPSS programfor windows 23.0. The research results show that there is a simultaneous or partial influence of motivation and knowledge on interest in investing in mutual funds, there is a simultaneous or partial influence of motivation and knowledge on mutual fund purchasing decisions, and there is an influence of interest in investing in mutual funds on mutual fund purchasing decisions. Based on the partial test results, it can be seen that motivation has the greatest influence on interest in investing in mutual funds and knowledge has the greatest influence on mutual fund purchasing decisions.

Content Framework for Modern Vehicle Technology Integration into Motor Vehicle Mechanic Work Curriculum in Technical Colleges in Gombe State, Nigeria

The main purpose of this study was to develop a content framework for inclusion of Modern Vehicle Technology into Motor Vehicle Mechanics Work MVMW curriculum in Government Science and Technical Colleges (GSTC) in Gombe State in order to enhance knowledge, attitude and skills for self-employment in modern vehicle maintenance and repairs and employable skills among MVMW trade students in technical colleges. The study was guided by 4 research questions. The population consisted of all the 30 MVMW trade teachers in Gombe State. The study adopted developmental research which was aimed to improve the current MVMW trade curriculum. A structured questionnaire was developed by the researcher with four point rating scale. The questionnaire was validated by four (4) experts from different field of Automobile Technology and trial tested on MVMW trade teachers. Mean and standard deviation was used to answer the responses while factor analysis and Cronbach Alpha was used to determine the validity and reliability of the instrument. The findings revealed that MVT content has four (4) units: these include: Introduction to MVT, Safety Rules and Regulation on MVT, Instrument for MVT Engine Testing and Measurement, It was recommended that: National Board for Technical Education (NBTE) should integrate these elements into the MVMW trade curriculum. Curriculum planners should adopt these clusters in designing the MVMW trade curriculum among other.

Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.

Geriatric emergency department (ED) guidelines emphasize timely identification of delirium. This article updates previous diagnostic accuracy systematic reviews of history, physical examination, laboratory testing, and ED screening instruments for the diagnosis of delirium as well as test-treatment thresholds for ED delirium screening. We conducted a systematic review to quantify the diagnostic accuracy of approaches to identify delirium. Studies were included if they described adults aged 60 or older evaluated in the ED setting with an index test for delirium compared with an acceptable criterion standard for delirium. Data were extracted and studies were reviewed for risk of bias. When appropriate, we conducted a meta-analysis and estimated delirium screening thresholds. Full-text review was performed on 55 studies and 27 were included in the current analysis. No studies were identified exploring the accuracy of findings on history or laboratory analysis. While two studies reported clinicians accurately rule in delirium, clinician gestalt is inadequate to rule out delirium. We report meta-analysis on three studies that quantified the accuracy of the 4 A's Test (4AT) to rule in (pooled positive likelihood ratio [LR+] 7.5, 95% confidence interval [CI] 2.7-20.7) and rule out (pooled negative likelihood ratio [LR-] 0.18, 95% CI 0.09-0.34) delirium. We also conducted meta-analysis of two studies that quantified the accuracy of the Abbreviated Mental Test-4 (AMT-4) and found that the pooled LR+ (4.3, 95% CI 2.4-7.8) was lower than that observed for the 4AT, but the pooled LR- (0.22, 95% CI 0.05-1) was similar. Based on one study the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is the superior instrument to rule in delirium. The calculated test threshold is 2% and the treatment threshold is 11%. The quantitative accuracy of history and physical examination to identify ED delirium is virtually unexplored. The 4AT has the largest quantity of ED-based research. Other screening instruments may more accurately rule in or rule out delirium. If the goal is to rule in delirium then the CAM-ICU or brief CAM or modified CAM for the ED are superior instruments, although the accuracy of these screening tools are based on single-center studies. To rule out delirium, the Delirium Triage Screen is superior based on one single-center study.