Nutrition Screening Adults

Nutrition Screening Adults

Welcome to the Nutrition Screening Adults Systematic Review 

Nutrition screening is the process of identifying patients, clients, or groups who may have a nutrition diagnosis and benefit from nutrition assessment and intervention by a registered dietitian nutritionist (RDN). Nutrition screening is a supportive task, which relies on tools that are quick and easy (<10 minutes to complete) to use and that requires minimal training. Use of valid and reliable tools are important to avoid under referral of patients or clients with malnutrition or over referral of patients or clients without malnutrition.

The project goal was to update and expand an existing EAL systematic review examining the validity and reliability of adult nutrition screening tools. Six tools for identifying risk for malnutrition (undernutrition) with sufficient evidence for evaluation were selected: Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment – Short Form (MNA-SF), Short Nutritional Assessment Questionnaire (SNAQ), Mini Nutrition Assessment-Short Form-Body Mass Index (MNA-SF-BMI), and Nutrition Risk Screening (NRS-2002). Studies were reviewed for validation of the tools across a variety of age groups, care settings, and acute and chronic medical conditions. The costs of the malnutrition screening procedure was also reviewed.

Key Findings 

The workgroup concluded:
 
•    The MST exhibited moderate validity, reliability, and agreement. The conclusion statement was supported by Grade I (Good/Strong) evidence. 
•    The conclusion statements for the remaining five tools were supported by Grade II (Fair) evidence: 
o    The MUST exhibited high validity, and moderate reliability and agreement 
o    The MNA-SF exhibited moderate validity and reliability and low agreement
o    The SNAQ exhibited moderate validity and reliability; no agreement data were available
o    The MNA-SF-BMI high validity and moderate agreement; no reliability data were available
o    The NRS-2002 exhibited moderate validity and agreement; no reliability data were available
•    Costs of the malnutrition screening procedure ranged from €2 (~$2.27 US) (SNAQ) in 2003 to €3.27 (~$2.93 US) (MNA-SF) in 2001, per hospital patient in the Netherlands. The conclusion statement was supported by Grade III (Limited) evidence.

Use the links on the left to view tool components and descriptions; validity and reliability criteria, definitions; procedure costs; and the evidence analysis. Expand the section below titled Project Team and Disclosures for a listing of individuals who contributed to the development of the systematic review, disclosures and project funding information.

 
  • Project Team and Disclosures (2010)
    The following individuals contributed their valuable time and expertise to the 2010 project:

    Workgroup Members
    • Maree Ferguson, MBA, PhD, RD, Chair
    • Victoria H. Castellanos, PhD, RD
    • Cinda Chima, MS, RD, LD
    • Judy Porcari, MBA, MS, RD
    • Nancy Nevin-Folino, MEd, RD, CSP, LD, FADA
    • Annalynn Skipper, PhD, RD, FADA
    • Pam Charney, PhD, RD  (resigned)
    Project Manager
    • Tami Piemonte, MS, RD, LDN
    Lead Analyst
    • Kyle Thompson, MS, RD, CSG, CD, CNSD
    Evidence Analysts
    • Julieanne Dzik Andereson, MPH, RD, LD
    • Kimberly Sasser Bandalier, MPH, RD, LD
    • Kathleen Burzynski, MS, RD, LD, CDE, CNSC
    • Alison Dvorak, MS, RD
    • Andrea Hutchins, PhD, RD
    • Karma Marino, PhD, MPH, RD
    • Patricia Mendoza, MS, RD, LD
    • Jen Nicholson, PhD, RD
    • Maureen K. Olson, MA, RD, LD
    • Julie Shertzer, MS, RD, LD
    Academy Staff
    • Deborah Cummins, PhD
    • Kay Howarter, MS, RD
    • Kari Kren, MPH, RD
    • Esther Myers, PhD, RD
    Financial Contributor
    • Academy of Nutrition and Dietetics
    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. All workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • None of the workgroup members listed above disclosed potential conflicts. 
  • Project Team and Disclosures (2018)
    The following individuals contributed their valuable time and expertise to this project:

    Workgroup Members
    • Annalynn Skipper, PhD, RDN, CNSC, FADA, Chair
      Manager, Health and Sciences, American Medical Association, Chicago, IL, USA
    • Pamela Charney, PhD, MS, RDN
      Associate Professor, University of North Georgia, Dawsonville, GA, USA
    • Anne E. Coltman, MS, RD, CNSC
      Clinical Nutrition Coordinator, Loyola University Medical Center, Maywood, IL, USA
    • Judith M. Porcari,  MBA, MS, RDN
      Adjunct Instructor, Lehman College and Queens College of the City University of New York, Bronx, NY, USA
    • Jennifer A. Tomesko, DCN, RD, CNSC
      Assistant Professor/Program Director, Rutgers University, School of Health Professions, Newark, NJ, USA
    • Erin Pover, MS RDN (resigned 3/14/18)
    Project Leaders
    • Tami A. Piemonte, MS, RDN, LDN, Project Manager
      Independent Contractor, St. Petersburg, FL, USA
    • Mary Katherine Hoy, EdD, RD, Lead Analyst (through October 2017)
      Nutritionists, ARS-USDA, Beltsville, MD, USA
    • Feon Cheng, PhD, MPH, RDN, Lead Analyst
      Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Deepa Handu, PhD, RN, Methodologist
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
    Evidence Analysts
    • Megan Baumler, PhD, RDN
       Professor, Mount Mary University, Milwaukee, WI, USA
    • Lisa A. Davis, MS, RD
      Dietitian/Nutritionist, University of Wisconsin Hospital & Clinics, Madison, WI, USA
    • Keiy C. Murofushi, MS, RDN
      Executive Director, Cedars-Sinai Medical Center, Beverly Hills, CA, USA
    • Jessica G. Redmond, PhD, RDN, FAND
      Assistant Professor, Syracuse University, Syracuse, NY, USA
    • Maja Redzic, PhD
      Research Associate, Huron Consulting Group, Chicago, IL, USA
    • Heather Valentine, MS, RD
      Research Administrative Assistant, University of Kansas Medical Center, Kansas City, KS, USA
    • Jessica West Schueler, MS, RDN
      Clinical Dietitian, St. Charles Health System, Bend, OR, USA
    • Jinyu Xu, PhD, MPH, RD
      Research Scientist, Nationwide Children’s Hospital, Columbus, OH, USA
    Financial Contributors
    • Commission on Dietetic Registration
    • Academy of Nutrition and Dietetics

    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • Annalynn Skipper: receives royalties for work on The Dietitian's Handbook of Enteral and Parenteral Nutrition
    • Pamela Charney: receives royalties for work on Pocket Guide to Nutrition Screening and Assessment