Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting

Summary Background & aims Numerous nutrition screening tools for the hospital setting have been developed. The aim of this systematic review is to study construct or criterion validity and predictive validity of nutrition screening tools for the general hospital setting. Methods A systematic rev...

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Bibliographic Details
Published in:Clinical nutrition (Edinburgh, Scotland) Scotland), 2014-02, Vol.33 (1), p.39-58
Main Authors: van Bokhorst-de van der Schueren, Marian A.E., PhD, RD, Guaitoli, Patrícia Realino, RD, Jansma, Elise P., MSc, de Vet, Henrica C.W., PhD
Format: Article
Language:English
Subjects:
Assessment
Biological and medical sciences
Construct validity
Feeding. Feeding behavior
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
Hospital
Hospitalization
Humans
Malnutrition
Malnutrition - diagnosis
Nutrition Assessment
Nutritional Status
Predictive validity
Screening
Systematic review
Validation Studies as Topic
Vertebrates: anatomy and physiology, studies on body, several organs or systems
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Summary:Summary Background & aims Numerous nutrition screening tools for the hospital setting have been developed. The aim of this systematic review is to study construct or criterion validity and predictive validity of nutrition screening tools for the general hospital setting. Methods A systematic review of English, French, German, Spanish, Portuguese and Dutch articles identified via MEDLINE, Cinahl and EMBASE (from inception to the 2nd of February 2012). Additional studies were identified by checking reference lists of identified manuscripts. Search terms included key words for malnutrition, screening or assessment instruments, and terms for hospital setting and adults. Data were extracted independently by 2 authors. Only studies expressing the (construct, criterion or predictive) validity of a tool were included. Results 83 studies (32 screening tools) were identified: 42 studies on construct or criterion validity versus a reference method and 51 studies on predictive validity on outcome (i.e. length of stay, mortality or complications). None of the tools performed consistently well to establish the patients' nutritional status. For the elderly, MNA performed fair to good, for the adults MUST performed fair to good. SGA, NRS-2002 and MUST performed well in predicting outcome in approximately half of the studies reviewed in adults, but not in older patients. Conclusions Not one single screening or assessment tool is capable of adequate nutrition screening as well as predicting poor nutrition related outcome. Development of new tools seems redundant and will most probably not lead to new insights. New studies comparing different tools within one patient population are required.
ISSN:0261-5614
1532-1983
DOI:10.1016/j.clnu.2013.04.008