Over the past 3 years, our delirium research group, a joint collaboration between Northeastern University and Tufts Medical Center has conducted a number of studies surrounding the identification and treatment of delirium in the ICU environment. (18, 26-29) A three-hospital evaluation lead by our group found that an educational intervention consisting of both patient cases using script concordance theory and a didactic presentation improved the ability of the bedside nurse to use the ICDSC correctly and to recognize delirium when compared to a judge. (26) Another study our group conducted found physician use of the ICDSC improves their ability to recognize delirium compared to a validated judge. (27) A large regional survey focusing on critical care nurse preferences and practices regarding delirium assessment compared delirium assessment practices to those for sedation assessment. (28) Finally, our group concluded a 36 patient double-blind randomized controlled trial evaluating the use of quetiapine for the delirium treatment in the ICU that was recently published in Critical Care Med. (29) The track record of our research group is important given the many challenges of implementing an ICU delirium-focused investigation such as the one that we have proposed. We therefore feel that we are qualified to conduct the study we have proposed to evaluate the safety and efficacy of haloperidol therapy in critically ill patients with subsyndromal delirium.