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Recommendations Summary

ONC: Nutrition Assessment 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: Nutrition Assesssment Tools for Adult Oncology Patients

    The registered dietitian nutritionist (RDN) should use an assessment tool validated in the setting (inpatient or ambulatory/outpatient) in which the tool is intended for use as part of the complete nutrition assessment. Research indicates that the following tools have been shown to elicit valid and reliable data as part of a comprehensive nutrition assessment of adult oncology patients in ambulatory and acute care settings:

    • Patient-Generated Subjective Global Assessment (PG-SGA)
    • Subjective Global Assessment (SGA).

    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

      Although costs of medical nutrition therapy (MNT) sessions and reimbursement vary, MNT is essential for improved outcomes.

    • Recommendation Narrative

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

      • Three positive-quality cross-sectional studies (Bauer et al, 2002; Isenring et al, 2003; Kwang and Kandiah, 2010)
      • Two positive-quality diagnostic, validity or reliability (DVR) studies (Laky et al, 2008; Read et al, 2005)
      • One neutral-quality descriptive study (Li et al, 2010)
      • One neutral-quality DVR study (Persson et al, 1999).

      Seven studies provide evidence that the PG-SGA and the SGA tools have been found to be valid and reliable in assessing the nutritional status of adult oncology patients in ambulatory and acute care settings: 

      • The MNA was found to have the sensitivity to diagnose oncology patients with malnutrition in the ambulatory setting, but was only moderately specific in identifying malnutrition when compared with the PG-SGA. The MNA was not evaluated in the acute care setting. 
      • Criteria for effective nutrition assessment tools in clinical settings include validity and reliability and the speed and ease with which the tool can be administered. Tools included in the evidence analysis for this question met the additional criteria of being validated in ambulatory or inpatient oncology settings.

    • Recommendation Strength Rationale

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

    • Minority Opinions

      None.