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Recommendations Summary

ONC: Malnutrition Screening Tools for Adult Oncology Patients 2013

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    ONC: Malnutrition Screening Tools for Adult Oncology Patients

    Adult oncology patients should be screened using a malnutrition screening tool validated in the setting (inpatient or ambulatory/outpatient) in which the tool is intended for use.  Research indicates that the following tools are valid and reliable for identifying malnutrition risk in oncology patients.

    The following have been shown to be valid and reliable for identifying malnutrition risk in adult oncology patients in the inpatient setting:

    • Malnutrition Screening Tool (MST)
    • Malnutrition Screening Tool for Cancer Patients (MSTC)
    • Malnutrition Universal Screening Tool (MUST)

    The following has been shown to be valid and reliable for identifying malnutrition risk in adult oncology patients in the ambulatory/outpatient setting:

    • MST.

    Rating: Strong
    Imperative

    • Risks/Harms of Implementing This Recommendation

      There are no potential risks or harms associated with the application of this recommendation.

    • Conditions of Application

      There are no conditions which may limit the application of this recommendation.

    • Potential Costs Associated with Application

      Costs include staff time to complete screening.

    • Recommendation Narrative

      A total of seven studies were included in the evidence analysis for this recommendation:

      • Three positive-quality diagnostic, validity or reliability studies (Amaral  et al, 2008; Ferguson, Capra et al, 1999; Kim et al, 2011)
      • Two positive-quality cross-sectional studies (Ferguson, Bauer et al, 1999; Isenring et al, 2006)
      • One neutral-quality diagnostic, validity or reliability studies (Kirsh et al, 2003)
      • One neutral-quality cross-sectional study (Bauer et al,  2003).

      Seven validation studies provide evidence that the following tools were found to be valid and reliable for identifying malnutrition in adult oncology patients.

      • Ambulatory and acute caresettings: MST (Amaral et al, 2008; Ferguson et al, 1999; Ferguson, Capra et al, 1999; Isenring et al, 2006)
      • Acute care setting only: MSTC (Kim et al, 2011) and MUST (Amaral et al, 2008)
      • The MAG-MST (Bauer, Capra et al, 2003) and the two-item nutrition screen from the ZSDS (Kirsh et al, 2003) were not found to be valid and reliable for identifying malnutrition in adult oncology patients in acute care settings
      • Validity and reliability of the MSTC, MUST, MAG-MST and two-item nutrition screen from the ZSDS tools were not evaluated in adult oncology patients in the ambulatory setting
      • Criteria for effective malnutrition screening tools in clinical settings include validity and reliability, the speed and ease with which the tool can be administered and the tool's ability to be used by a variety of members of the Interdisciplinary Team. Tools included in the evidence analysis for this question met the additional criteria of being validated in ambulatory or inpatient oncology settings.
      • For further information regarding nutrition screening in other non-cancer populations within the EAL, see the Nutrition Screening Project.

    • Recommendation Strength Rationale

      Conclusion statement for the validity and reliability of malnutrition screening tools to assess nutritional status of adult oncology patients in ambulatory and acute care settings is Grade I.

    • Minority Opinions

      None.