Abstract
Background
Malnutrition screening relies on quick and easy-to-use tools that require minimal
training of users. Valid and reliable tools should avoid under-referral of adults
with a malnutrition diagnosis or over-referral of those without a malnutrition diagnosis
to dietitians.
Objective
Our aim was to conduct a systematic review of adult malnutrition screening tools for
validity, agreement, and reliability, and to determine the costs of the malnutrition
screening procedure.
Methods
Following a structured process, a comprehensive search using PubMed, MEDLINE, EMBASE,
and CINAHL was conducted for relevant research published between 1997 and 2017 that
examined the validity, agreement, reliability, and costs of nutrition screening tools.
Results
Sixty-nine studies met the inclusion criteria. The Malnutrition Screening Tool exhibited
moderate validity, agreement, and reliability based on Grade I (Good/Strong) evidence. The evidence supporting the conclusions for the remaining tools was Fair (Grade II). The Malnutrition Universal Screening Tool exhibited high validity and
moderate agreement and reliability. The Mini Nutritional Assessment–Short Form exhibited
moderate validity and reliability and low agreement. The Short Nutritional Assessment
Questionnaire and the Nutrition Risk Screening 2002 exhibited moderate validity and
reliability and the Mini Nutritional Assessment–Short Form Body Mass Index exhibited
high validity and moderate agreement. However, these last three tools were missing
reliability or agreement data. Limited data were available to evaluate malnutrition
screening costs.
Conclusions
This review provides an analysis of validity, agreement, and reliability of tools
to screen adults for malnutrition, regardless of their age, medical history, or location.
No tools were found with high validity, reliability, and strong supportive evidence.
Tools most often achieved moderate validity, agreement, and reliability, and had large
variations in individual results. The minimum validity and reliability of tools to
screen adults for malnutrition should be established to shape future research. Cost
data for the screening process should be obtained and examined.
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Biography
A. Skipper is a health and science manager, American Medical Association, Chicago, IL.
Biography
A. Coltman is a patient services manager, Trinity Health, Melrose Park, IL.
Biography
J. Tomesko is an assistant professor and program director, Rutgers University, School of Health Professions, Newark, NJ.
Biography
P. Charney is an associate professor, University of North Georgia, Dahlonega, GA.
Biography
J. Porcari is an adjunct instructor, Lehman College, Bronx, NY.
Biography
T. A. Piemonte is a project manager/consultant, Evidence Analysis Center, D. Handu is director and F. W. Cheng is a nutrition researcher, Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL
Article Info
Publication History
Published online: December 19, 2019
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. Dr Skipper is an employee of the American Medical Association (AMA), but the views expressed in this document are her own and cannot be interpreted as AMA policy.
FUNDING/SUPPORT The Academy of Nutrition and Dietetics and the Commission on Dietetic Registration provided funding for the development of the systematic review. This includes funding for the project manager, medical librarian, analysts, and copy editors.
Identification
Copyright
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