scholarly journals Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rachel Deer ◽  
Mackenzie McCall ◽  
Elena Volpi

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs

2017 ◽  
Vol 21 (3) ◽  
pp. 109-117
Author(s):  
Ayşegül Albay ◽  
Bengü Şaylan ◽  
Hacer Sali Çakır ◽  
Sema Basat

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 181-183
Author(s):  
Michael E. Thase ◽  
Stephen M. Stahl ◽  
Roger S. McIntyre ◽  
Tina Matthews-Hayes ◽  
Mehul Patel ◽  
...  

AbstractIntroductionAlthough mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.FundingAbbVie Inc.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nichtima Chayaopas ◽  
Pornthep Kasemsiri ◽  
Panida Thanawirattananit ◽  
Patorn Piromchai ◽  
Kwanchanok Yimtae

Abstract Background Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation. Trial registration The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.


2014 ◽  
Vol 33 ◽  
pp. S74
Author(s):  
V. Aviles ◽  
H. Segurola ◽  
M. Comas ◽  
G. Cárdenas ◽  
N. Castillejos ◽  
...  

1993 ◽  
Vol 28 (7) ◽  
pp. 69-76 ◽  
Author(s):  
Peter Pompei ◽  
Christine K. Cassel

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