A novel, automated nutrition screening system as a predictor of nutritional risk in an oncology day treatment unit (ODTU)

J. Abbott, L. Teleni, D. McKavanagh, J. Watson, A. McCarthy, E. Isenring

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Abstract

Purpose: Paper-based nutrition screening tools can be challenging to implement in the ambulatory oncology setting. The aim of this study was to determine the validity of the Malnutrition Screening Tool (MST) and a novel, automated nutrition screening system compared to a 'gold standard' full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). 

Methods: An observational, cross-sectional study was conducted in an outpatient oncology day treatment unit (ODTU) within an Australian tertiary health service. Eligibility criteria were as follows: ≥18 years, receiving outpatient anticancer treatment and English literate. Patients self-administered the MST. A dietitian assessed nutritional status using the PG-SGA, blinded to the MST score. Automated screening system data were extracted from an electronic oncology prescribing system. This system used weight loss over 3 to 6 weeks prior to the most recent weight record or age-categorised body mass index (BMI) to identify nutritional risk. Sensitivity and specificity against PG-SGA (malnutrition) were calculated using contingency tables and receiver operating curves. 

Results: There were a total of 300 oncology outpatients (51.7 % male, 58.6±13.3 years). The area under the curve (AUC) for weight loss alone was 0.69 with a cut-off value of ≥1 % weight loss yielding 63 % sensitivity and 76.7 % specificity. MST (score ≥2) resulted in 70.6 % sensitivity and 69.5 % specificity, AUC 0.77. 

Conclusions: Both the MST and the automated method fell short of the accepted professional standard for sensitivity (∼≥80 %) derived from the PG-SGA. Further investigation into other automated nutrition screening options and the most appropriate parameters available electronically is warranted to support targeted service provision.

Original languageEnglish
Pages (from-to)2107-2112
Number of pages6
JournalSupportive Care in Cancer
Volume22
Issue number8
DOIs
Publication statusPublished - 2014

Fingerprint

Malnutrition
Weight Loss
Outpatients
Sensitivity and Specificity
Area Under Curve
Therapeutics
Electronic Prescribing
Operating Tables
Nutrition Assessment
Nutritionists
Nutritional Status
Information Systems
Health Services
Body Mass Index
Cross-Sectional Studies
Weights and Measures

Cite this

Abbott, J. ; Teleni, L. ; McKavanagh, D. ; Watson, J. ; McCarthy, A. ; Isenring, E. / A novel, automated nutrition screening system as a predictor of nutritional risk in an oncology day treatment unit (ODTU). In: Supportive Care in Cancer. 2014 ; Vol. 22, No. 8. pp. 2107-2112.
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abstract = "Purpose: Paper-based nutrition screening tools can be challenging to implement in the ambulatory oncology setting. The aim of this study was to determine the validity of the Malnutrition Screening Tool (MST) and a novel, automated nutrition screening system compared to a 'gold standard' full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: An observational, cross-sectional study was conducted in an outpatient oncology day treatment unit (ODTU) within an Australian tertiary health service. Eligibility criteria were as follows: ≥18 years, receiving outpatient anticancer treatment and English literate. Patients self-administered the MST. A dietitian assessed nutritional status using the PG-SGA, blinded to the MST score. Automated screening system data were extracted from an electronic oncology prescribing system. This system used weight loss over 3 to 6 weeks prior to the most recent weight record or age-categorised body mass index (BMI) to identify nutritional risk. Sensitivity and specificity against PG-SGA (malnutrition) were calculated using contingency tables and receiver operating curves. Results: There were a total of 300 oncology outpatients (51.7 {\%} male, 58.6±13.3 years). The area under the curve (AUC) for weight loss alone was 0.69 with a cut-off value of ≥1 {\%} weight loss yielding 63 {\%} sensitivity and 76.7 {\%} specificity. MST (score ≥2) resulted in 70.6 {\%} sensitivity and 69.5 {\%} specificity, AUC 0.77. Conclusions: Both the MST and the automated method fell short of the accepted professional standard for sensitivity (∼≥80 {\%}) derived from the PG-SGA. Further investigation into other automated nutrition screening options and the most appropriate parameters available electronically is warranted to support targeted service provision.",
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A novel, automated nutrition screening system as a predictor of nutritional risk in an oncology day treatment unit (ODTU). / Abbott, J.; Teleni, L.; McKavanagh, D.; Watson, J.; McCarthy, A.; Isenring, E.

In: Supportive Care in Cancer, Vol. 22, No. 8, 2014, p. 2107-2112.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Abbott, J.

AU - Teleni, L.

AU - McKavanagh, D.

AU - Watson, J.

AU - McCarthy, A.

AU - Isenring, E.

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N2 - Purpose: Paper-based nutrition screening tools can be challenging to implement in the ambulatory oncology setting. The aim of this study was to determine the validity of the Malnutrition Screening Tool (MST) and a novel, automated nutrition screening system compared to a 'gold standard' full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: An observational, cross-sectional study was conducted in an outpatient oncology day treatment unit (ODTU) within an Australian tertiary health service. Eligibility criteria were as follows: ≥18 years, receiving outpatient anticancer treatment and English literate. Patients self-administered the MST. A dietitian assessed nutritional status using the PG-SGA, blinded to the MST score. Automated screening system data were extracted from an electronic oncology prescribing system. This system used weight loss over 3 to 6 weeks prior to the most recent weight record or age-categorised body mass index (BMI) to identify nutritional risk. Sensitivity and specificity against PG-SGA (malnutrition) were calculated using contingency tables and receiver operating curves. Results: There were a total of 300 oncology outpatients (51.7 % male, 58.6±13.3 years). The area under the curve (AUC) for weight loss alone was 0.69 with a cut-off value of ≥1 % weight loss yielding 63 % sensitivity and 76.7 % specificity. MST (score ≥2) resulted in 70.6 % sensitivity and 69.5 % specificity, AUC 0.77. Conclusions: Both the MST and the automated method fell short of the accepted professional standard for sensitivity (∼≥80 %) derived from the PG-SGA. Further investigation into other automated nutrition screening options and the most appropriate parameters available electronically is warranted to support targeted service provision.

AB - Purpose: Paper-based nutrition screening tools can be challenging to implement in the ambulatory oncology setting. The aim of this study was to determine the validity of the Malnutrition Screening Tool (MST) and a novel, automated nutrition screening system compared to a 'gold standard' full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: An observational, cross-sectional study was conducted in an outpatient oncology day treatment unit (ODTU) within an Australian tertiary health service. Eligibility criteria were as follows: ≥18 years, receiving outpatient anticancer treatment and English literate. Patients self-administered the MST. A dietitian assessed nutritional status using the PG-SGA, blinded to the MST score. Automated screening system data were extracted from an electronic oncology prescribing system. This system used weight loss over 3 to 6 weeks prior to the most recent weight record or age-categorised body mass index (BMI) to identify nutritional risk. Sensitivity and specificity against PG-SGA (malnutrition) were calculated using contingency tables and receiver operating curves. Results: There were a total of 300 oncology outpatients (51.7 % male, 58.6±13.3 years). The area under the curve (AUC) for weight loss alone was 0.69 with a cut-off value of ≥1 % weight loss yielding 63 % sensitivity and 76.7 % specificity. MST (score ≥2) resulted in 70.6 % sensitivity and 69.5 % specificity, AUC 0.77. Conclusions: Both the MST and the automated method fell short of the accepted professional standard for sensitivity (∼≥80 %) derived from the PG-SGA. Further investigation into other automated nutrition screening options and the most appropriate parameters available electronically is warranted to support targeted service provision.

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JO - Supportive Care in Cancer

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SN - 0941-4355

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