EAL

NSP: Validity and Reliability of Nutrition Screening Tools (2018)

Fourteen pediatric nutrition screening tools to identify risk of malnutrition related to under- or over-nutrition were evaluated to determine validity and reliability. These included:

Inpatient/Hospital Setting

IMCI (Integrated Management of Childhood Illness)
PeDiSMART (Pediatric Digital Scaled Malnutrition Risk screening Tool)
PMST (Paediatric Malnutrition Screening Tool)
PNRS (Pediatric Nutrition Risk Score)
PNST (Pediatric Nutrition Screening Tool)
PYMS (Paediatric Yorkhill Malnutrition Score)*
STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics)*
STRONGkids (Screening Tool for Risk on Nutritional Status and Growth)

Outpatient or Specialty Clinic Setting

NRST-CF (Nutrition Risk Screening Tool for Children and Adolescents with Cystic Fibrosis)*
SCAN (Nutrition Screening Tool for Childhood Cancer)
STAMP-modified (Screening Tool for the Assessment of Malnutrition in Pediatrics-modified)

Community Setting

E-Kindex (Electronic Kids Dietary Index)
NutriSTEP (Nutrition Screening Tool for Every Preschooler)
Toddler NutriSTEP

*Tools found to have either Grade I (Strong) or Grade II (Fair) evidence for moderate to high validity and reliability.

Download a copy of the Summary Table (PDF) of all tools. See the conclusion statement and evidence summary for each tool below.

Assessment
What is the validity and reliability of the Electronic Kids Dietary Index (E-KINDEX) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  E-KINDEX demonstrated a low degree of validity in identifying malnutrition risk related to obesity and overweight and a low degree of validity in identifying malnutrition risk related to obesity alone in pre-adolescent children. Internal reliability of the tool was low. Agreement and inter-rater reliability were not reported.
- Grade: III
  - 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: What is the validity and reliability of the Electronic Kids Dietary Index (E-KINDEX) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Lazarou C, Panagiotakos DB,Spanoudis G, Matalas AL.. E-KINDEX: a dietary screening tool to assess children's obesogenic dietary habits. . Journal of the American College of Nutrition. 2011; 30:100-112.
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Integrated Management of Childhood Illness (IMCI) Nutrition Algorithm for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  The ICMI algorithm demonstrated a low degree of validity in identifying risk of malnutrition, based on visual observations of either severe wasting, bipedal edema, severe wasting or bipedal edema, or stunted growth, and a moderate degree of validity in identifying risk of malnutrition, based on very low weight for age, in children admitted to the hospital. Agreement and reliability of the tool were not reported.
- Grade: III
  - 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: What is the validity and reliability of the Integrated Management of Childhood Illness (IMCI) nutrition algorithm for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Hamer C, Kvatum K, Jeffries D, Allen S. Detection of severe protein-energy malnutrition by nurses in The Gambia. Archives of Disease in Childhood. 2004; 89:181-184.
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Nutrition Risk Screening Tool for Cystic Fibrosis (NRST for CF) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  The NRST for CF demonstrated a moderate degree of validity in identifying risk of malnutrition in children and adolescents with CF. Inter-rater reliability was high. Agreement of the tool was not reported.
- Grade: II
  - 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: What is the validity and reliability of the Nutrition Risk Screening Tool for Cystic Fibrosis (NRST for CF) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    McDonald CM.. Validation of a nutrition risk screening tool for children and adolescents with cystic fibrosis ages 2-20 years. Journal of Pediatric Gastroenterology and Nutrition. 2008; 46:438-446.
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of Nutrition Screening Tool for Every Preschooler (NutriSTEP) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  NutriSTEP demonstrated a low degree of validity in identifying risk for malnutrition according to moderate risk and high risk cut points and a high test-retest reliability in preschool children. Agreement of the tool was high. Inter-rater reliability was not reported.
- Grade: III
  - 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: What is the validity and reliability of Nutrition Screening Tool for Every Preschooler (NutriSTEP) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Toddler Nutrition Screening Tool for Every Preschooler (Toddler NutriSTEP) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  The Toddler NutriSTEP demonstrated a moderate degree of validity in identifying risk of malnutrition according to moderate risk and high risk cut points and a high test-retest reliability in toddlers. Agreement and inter-rater reliability of the tool were not reported.
- Grade: III
  - 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: What is the validity and reliability of Toddler Nutrition Screening Tool for Every Preschooler (Toddler NutriSTEP) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Pediatric Digital Scaled Malnutrition Risk Screening Tool (PeDiSMART) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  No evidence meeting inclusion criteria was found to evaluate the validity and reliability of the PeDiSMART for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population.
- Grade: V
  - 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.
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Paediatric Malnutrition Screening Tool (PMST) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  PMST demonstrated a moderate degree of validity in identifying risk of malnutrition in children admitted to the hospital. Agreement of the tool was low. Reliability was not reported.
- Grade: II
  - 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: What is the validity and reliability of the Paediatric Malnutrition Screening Tool (PMST) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Thomas P, Marino L, Williams S, Beattie R. Outcome of nutritional screening in the acute paediatric setting. Archives of Disease in Childhood. 2016; 101:1,119-1,124.
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of Pediatric Nutrition Risk Score (PNRS) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  PNRS demonstrated a moderate degree of validity in identifying risk of malnutrition in children. Agreement of the tool was low. Reliability was not reported.
- Grade: III
  - 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: What is the validity and reliability of Pediatric Nutrition Risk Score (PNRS) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of Pediatric Nutrition Screening Tool (PNST) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  PNST demonstrated a moderate degree of validity in identifying risk of malnutrition in hospitalized children based on either weight for age Z-score or body mass index (BMI) Z-score, and a low degree of validity in identifying risk of malnutrition in hospitalized children based on either height for age z-score, BMI in at least 85th percentile or dietitian assessment. Agreement and reliability of the tool were not reported.
- Grade: II
  - 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: What is the validity and reliability of Pediatric Nutrition Screening Tool (PNST) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    White M, Lawson K, Ramsey R, Dennis N, Hutchinson Z, Soh X, Matsuyama M, Doolan A, Todd A, Elliott A, Bell K, Littlewood R. Simple Nutrition Screening Tool for Pediatric Inpatients. JPEN. Journal of Parenteral and Enteral Nutrition. 2016; 40:392-398
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Paediatric Yorkhill Malnutrition Score (PYMS) for identifying risk of malnutrition related to under-nutrition or over-nutrition in the pediatric population?
- Conclusion
  PYMS demonstrated a moderate degree of validity, low agreement and a moderate degree of inter-rater reliability in identifying risk of malnutrition in hospitalized children.
- Grade: II
  - 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: What is the validity and reliability of Paediatric Yorkhill Malnutrition Score (PYMS) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Nutrition Screening Tool for Childhood Cancer (SCAN) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  The SCAN demonstrated a moderate degree of validity in identifying risk of malnutrition in inpatient children being treated for cancer. Agreement and reliability of the tool were not reported.
- Grade: III
  - 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: What is the validity and reliability of the Nutrition Screening Tool for Childhood Cancer (SCAN) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Murphy A, White M, Viani K, Mosby T. Evaluation of the nutrition screening tool for childhood cancer (SCAN). Clinical Nutrition (Edinburgh, Scotland) 2016; 35:219-224
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for identifying risk of malnutrition related to under-nutrition or over-nutrition in the pediatric population?
- Conclusion
  STAMP demonstrated a moderate degree of validity in identifying risk for malnutrition in hospitalized children. Tool agreement was low, but inter-rater reliability was high.
- 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: What is the validity and reliability of the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for identifying risk of malnutrition related to under-nutrition or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of the Modified Screening Tool for the Assessment of Malnutrition in Pediatrics (Modified STAMP) for identifying risk of malnutrition related to under- over-nutrition in the pediatric population?
- Conclusion
  The Modified STAMP demonstrated a low degree of validity in identifying risk of malnutrition in children seen for intercurrent disease in outpatient clinics. Agreement of the tool was low. Reliability was not reported.
- Grade: II
  - 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: What is the validity and reliability of modified Screening Tool for the Assessment of Malnutrition in Pediatrics (Modified STAMP) for identifying risk of malnutrition related to under- over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
What is the validity and reliability of Screening Tool for Risk on Nutritional status and Growth (STRONGkids) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Conclusion
  STRONG_kidsdemonstrated a moderate degree of validity in identifying risk for malnutrition in hospitalized children. Agreement of the tool was low. Inter- and intra-rater reliability were moderate.
- Grade: II
  - 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: What is the validity and reliability of the Screening Tool for Risk on Nutritional status and Growth (STRONGkids) for identifying risk of malnutrition related to under- or over-nutrition in the pediatric population?
- Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017

Nutrition Screening Pediatrics

NSP: Validity and Reliability of Nutrition Screening Tools (2018)