A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting

Skye Marshall, Dana L. Craven, Jaimon T Kelly, Elisabeth Isenring

Research output: Contribution to conferencePosterResearch

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Abstract

Background: Accurate diagnosis is a key step in managing protein-energy malnutrition. This review seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of proteinenergy malnutrition in community-living older adults. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6,412 records identified, of which eight papers were included. Two studies evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95%CI: 1.55-2.39]; P<0.00001; n=2,013 participants; n=4 studies; I2: 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P=0.01; n=4,046 participants; n=3 studies; I2:89%). Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing protein-energy malnutrition in older adults in the community setting. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.
Original languageEnglish
Pages32
Number of pages1
Publication statusPublished - Nov 2017
Event43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition: Collaboration in Clinical Nutrition – Evidence Based Nutrition for Improving Patient Outcomes - Royal Pines Conference Centre, Gold Coast, Australia
Duration: 16 Nov 201718 Nov 2017
Conference number: 43rd

Conference

Conference43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition
Abbreviated titleAuSPEN 2017
CountryAustralia
CityGold Coast
Period16/11/1718/11/17

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Protein-Energy Malnutrition
Nutrition Assessment
Meta-Analysis
Malnutrition
Databases
Health
Proteins

Cite this

Marshall, S., Craven, D. L., Kelly, J. T., & Isenring, E. (2017). A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting. 32. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
Marshall, Skye ; Craven, Dana L. ; Kelly, Jaimon T ; Isenring, Elisabeth. / A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.1 p.
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abstract = "Background: Accurate diagnosis is a key step in managing protein-energy malnutrition. This review seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of proteinenergy malnutrition in community-living older adults. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6,412 records identified, of which eight papers were included. Two studies evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95{\%}CI: 1.55-2.39]; P<0.00001; n=2,013 participants; n=4 studies; I2: 0{\%}). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95{\%}CI: 0.24-1.80]; P=0.01; n=4,046 participants; n=3 studies; I2:89{\%}). Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing protein-energy malnutrition in older adults in the community setting. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.",
author = "Skye Marshall and Craven, {Dana L.} and Kelly, {Jaimon T} and Elisabeth Isenring",
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Marshall, S, Craven, DL, Kelly, JT & Isenring, E 2017, 'A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting' 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia, 16/11/17 - 18/11/17, pp. 32.

A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting. / Marshall, Skye; Craven, Dana L.; Kelly, Jaimon T; Isenring, Elisabeth.

2017. 32 Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.

Research output: Contribution to conferencePosterResearch

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AU - Craven, Dana L.

AU - Kelly, Jaimon T

AU - Isenring, Elisabeth

PY - 2017/11

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N2 - Background: Accurate diagnosis is a key step in managing protein-energy malnutrition. This review seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of proteinenergy malnutrition in community-living older adults. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6,412 records identified, of which eight papers were included. Two studies evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95%CI: 1.55-2.39]; P<0.00001; n=2,013 participants; n=4 studies; I2: 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P=0.01; n=4,046 participants; n=3 studies; I2:89%). Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing protein-energy malnutrition in older adults in the community setting. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.

AB - Background: Accurate diagnosis is a key step in managing protein-energy malnutrition. This review seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of proteinenergy malnutrition in community-living older adults. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6,412 records identified, of which eight papers were included. Two studies evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95%CI: 1.55-2.39]; P<0.00001; n=2,013 participants; n=4 studies; I2: 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P=0.01; n=4,046 participants; n=3 studies; I2:89%). Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing protein-energy malnutrition in older adults in the community setting. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.

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M3 - Poster

SP - 32

ER -

Marshall S, Craven DL, Kelly JT, Isenring E. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting. 2017. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.