Validity of the malnutrition screening tool as an effective predictor of nutritional risk in oncology outpatients receiving chemotherapy
- 2.3k Downloads
Goals of work
To determine the relative validity of the Malnutrition Screening Tool (MST) compared with a full nutrition assessment by the scored Patient Generated-Subjective Global Assessment (PG-SGA) and to assess MST inter-rater reliability in patients receiving chemotherapy.
Patients and methods
An observational, cross-sectional study was conducted at an Australian public hospital in 50 oncology outpatients receiving chemotherapy. Inter-rater reliability was assessed in a subsample of 20 patients.
According to PG-SGA global rating, the prevalence of malnutrition was 26%. The MST was a strong predictor of nutritional risk relative to the PG-SGA (100% sensitivity, 92% specificity, 0.8 positive predictive value, 1.0 negative predictive value). MST inter-rater reliability was acceptable with agreement by administration staff/nursing staff/patient and the dietitian in 18/20 cases (kappa=0.83; p0.001).
The MST has acceptable relative validity, inter-rater reliability, sensitivity, and specificity to identify chemotherapy outpatients at risk of malnutrition and, hence, is an acceptable nutrition screening tool in this patient population.
KeywordsDietetics Nutrition screening Oncology Cancer Chemotherapy
We would like to thank Silvia Hui, Kanita Kunaratnam, Kellie Wright, and Lydia Yuen for assisting with data collection as part of the requirements for the Master of Nutrition and Dietetics.
- 1.Ollenschlager G, Viell B, Konkol K, Burger B (1991) Tumor anorexia: causes, assessment, treatment. Recent Results Cancer Res 121:20–27Google Scholar
- 10.Ferguson M, Capra S (1998) Nutrition screening practices in Australian hospitals. Aust J Nutr Diet 55:157–161Google Scholar
- 13.McWhirter JP, Pennington CR (1994) Incidence and recognition of malnutrition in hospital. Br Med J 308:945–948Google Scholar
- 14.Ottery FD (2000) Patient generated subjective global assessment. In: McCallum P, Polisena C (eds) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, IL, USA, pp 11–23Google Scholar
- 21.National Health and Medical Research Council (2003) Clinical practice guidelines for the management of overweight and obesity in adults. Commonwealth of Australia. Canberra, AustraliaGoogle Scholar
- 24.Segura A, Pardo J, Jara C, Zugazabeitia L, Curulla J, de las Penas R, Garcia-Cabrera E, Azuara M, Casado J, Gomez-Candela C (2005) An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advance or metastatic cancer. Clin Nutr 24:801–814CrossRefPubMedGoogle Scholar
- 26.Stratton RJ, Hackston A, Longmore D, Dixon R, Price S, Stroud M, King C, Elia M (2004) Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool’ (MUST) for adults. Br J Nutr 92:799–808CrossRefPubMedGoogle Scholar
- 27.Rubestein LZ, Harker JO, Salva A, Guigoz Y, Vellas B (2001) Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol Ser A Biol Sci Med Sci 56:M366–M372Google Scholar