Validated Nutrition Screening Tools

Part of a presentation given at the Canadian Nutrition Society Conference Manon Laporte PDt, MSc June 2013

Validated Nutrition Screening Tools (for hospital use)

 Simple Screening Tools (# 1 & # 2)

 Malnutrition Screening Tool (MST)  Mini Nutritional Assessment – Short Form (MNA-SF)  Nutritional Risk Screening 2002 (NRS 2002)  Malnutrition Universal Screening Tool (MUST)  Short Nutritional Assessment Questionnaire (SNAQ)

Parameters Screening Tools Simple Screening tools 1998 #1 #2 MST 1999

Weight loss



BMI

Appetite/ Food intake

 



Criterion Validity Others

Albumin







In-depth assessment by dietitians (2 studies) SGA (4 studies)

 Psycho. stress

MNA-SF© 2001

Gold Standard

Acute disease Neuropsycho. problems Mobility

- Dietitian assessment - SGA - Full MNA (4 studies)

Sensitivity

Specificity

75% 92%

75% 69%

74%-93%

76%-93%

93%

38%

100%

52.8%

64%-96%

89%-100%

NRS 2002







Severity of disease

SGA (5 studies)

62% - 90%

83.3%-93%

MUST 2003







Acutely ill

SGA (4 studies)

61%-87.1%

78.6%-93%

SNAQ © 2005





Use of : Supplemental drinks or

% Weight loss & BMI SGA (2012)

79%

83%

79%

90.3%

Screening Tools Screening Tools 1998 # 1 #2

MST 1999

MNA-SF© 2001

NRS 2002

Reliability (inter-rater) Kappa Score 0.60 0.76

0.84 – 0.93

Not reported

0.67

Simple / Easy to use?

±

Yes

Limits

• •

Calculation of % weight loss Laboratory parameter

•

Eating poorly: only because  appetite & No time frame of eating poorly Validity 93% - developmental study

•

No

• • •

No

• Low sensitivity • Too detailed (% of food intake and weight loss)

• MUST 2003

Not reported

±

• •

SNAQ

©

2005

0.69 – 0.91

± Yes

•

Low specificity For elderly population only Too comprehensive

Calculation of % weight loss in specific time frames Same BMI range for adult and elderly populations No acceptable reference standard (EAL-ADA 2011) Decrease appetite over the last