EAL

ONC: Malnutrition Screening and Nutrition Assessment of Adult Oncology Patients (2012)

Overview

The Academy's Oncology Expert Work Group reviewed articles on screening and assessment in the oncology population in order to evaluate the available tools and provide evidence-based guidance for the oncology dietitian caring for those patients experiencing nutrition impact symptoms or those at risk for malnutrition.

The Work Group chose to limit the definition of malnutrition to under-nutrition, recognizing that other areas of practice have a broader interpretation that includes both under- and over-nutrition or nutrient imbalance, rather than inadequate caloric intake.

For an explantion of nutrition, malnutrition screening and nutrition assessment of the oncology patient, visit the Guideline Introduction page titled Nutrtion and the Adult Oncology Patient (click here).

For the Oncology Work Group's suggestions for future research on this topic, see ONC: Future Research Suggestions on the left.

Assessment
Which malnutrition screening tools have been found to be valid and reliable for identifying malnutrition risk in adult oncology patients in ambulatory and acute care settings?
- Conclusion
  Seven validation studies met inclusion criteria for this question. These tools were found to be valid and reliable for identifying malnutrition risk in adult oncology patients as follows:
  
  Ambulatory and acute care settings
  - MST
  Acute care setting only
  - MSTC
  - MUST.
  The MAG-MST and the 2-item nutrition screen from the ZSDS were not found to be valid and reliable for identifying malnutrition risk in adult oncology patients in acute care settings.
  
  Validity and reliability of the MSTC, MUST, MAG-MST and 2-item nutrition screen from the ZSDS tools were not evaluated in adult oncology patients in the ambulatory setting.
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Which malnutrition screening tools have been found to be valid and reliable for identifying malnutrition risk in adult oncology patients in ambulatory and acute care settings?
- Search Plan and Results: ONC: Malnutrition Screening, Nutrition Assessment Tools and Outcomes for Oncology Patients 2011
Which nutrition assessment tools have been found to be valid and reliable to assess nutritional status of adult oncology patients in ambulatory and acute care settings?
- Conclusion
  Seven studies met inclusion criteria for this question. The following tools have been found to be valid and reliable in assessing the nutritional status of adult oncology patients in ambulatory and acute care settings:
  - PG-SGA
  - SGA.
  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.
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Which nutrition assessment tools have been found to be valid and reliable to assess nutritional status of adult oncology patients in ambulatory and acute care settings?
- Search Plan and Results: ONC: Malnutrition Screening, Nutrition Assessment Tools and Outcomes for Oncology Patients 2011