Nutrition Screening Pediatrics

NSP: Users of Tools (2018)

• Assessment
  Is there a difference in validity among users of nutrition screening tools?

  • Conclusion
    Differences in individual validity measures for sensitivity, specificity, and positive and negative predictive values among different users of the tools were found. The overall validity of the tools was different between dietitians administering Nutrition Risk Screening Tool for Children and Adolescents with CF (NRST-CF) and between dietitians and nurses administering Pediatric Yorkhill Malnutrition Score (PYMS). However, the overall validity of tools was the same when experts (dietitians or experienced physicians) and non-experts (inexperienced nurses and physicians) administered Screening Tool for the Assessment of Malnutrition (STAMP) and when pediatricians and nurses administered Screening Tool for Risk on Nutritional Status and Growth (STRONG_kids). The relevance of these findings on the impact to the overall validity of each screening tool is unclear. 
  • 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: Is there a difference in validity among users of nutrition screening tools?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Galera-Martínez R, Moráis-López A, Rivero de la Rosa M, Escartín-Madurga L, López-Ruzafa E, Ros-Arnal I, Ruiz-Bartolomé H, Rodríguez-Martínez G, Lama-More R. Reproducibility and Inter-rater Reliability of 2 Paediatric Nutritional Screening Tools. Journal of Pediatric Gastroenterology and Nutrition 2017; 64:e65-e70
      • Gerasimidis K, Keane O, Macleod I, Flynn D, Wright C. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital. The British Journal of Nutrition. 2010; 104:751-756.
      • 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.
      • Moeeni V, Walls T, Day A. The STRONGkids nutritional risk screening tool can be used by paediatric nurses to identify hospitalised children at risk. Acta Paediatrica (Oslo, Norway: 1992). 2014; 103:e528-531.
  • Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017
     
  Is there a difference in reliability among users of nutrition screening tools?

  • Conclusion
    Inter-rater reliability varied according to nutrition screening tool examined and types of users that were compared. Inter-rater reliability was moderate to high between dietitians [Screening Tool for the Assessment of Malnutrition (STAMP) and Nutrition Risk Screening Tool for Children and Adolescents with CF (NRST-CF)] and between nurses [Screening Tool for Risk on Nutritional Status and Growth (STRONG_kids) and STAMP], and moderate between pediatricians and nurses (STRONG_kids) and experts and non-experts (STAMP and STRONG_kids). Inter-rater reliability was low between dietitians and nurses [Pediatric Yorkhill Malnutrition Score (PYMS)].
  • 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: Is there a difference in reliability among users of nutrition screening tools?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Galera-Martínez R, Moráis-López A, Rivero de la Rosa M, Escartín-Madurga L, López-Ruzafa E, Ros-Arnal I, Ruiz-Bartolomé H, Rodríguez-Martínez G, Lama-More R. Reproducibility and Inter-rater Reliability of 2 Paediatric Nutritional Screening Tools. Journal of Pediatric Gastroenterology and Nutrition 2017; 64:e65-e70
      • Gerasimidis K, Keane O, Macleod I, Flynn D, Wright C. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital. The British Journal of Nutrition. 2010; 104:751-756.
      • Huysentruyt K, Alliet P, Muyshont L, Rossignol R, Devreker T, Bontems P, Dejonckheere J, Vandenplas Y, De Schepper J. The STRONG(kids) nutritional screening tool in hospitalized children: a validation study. Nutrition (Burbank, Los Angeles County, Calif.). ; 29:1356-1361
      • McCarthy H, Dixon M, Crabtree I, Eaton-Evans M, McNulty H. The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP©) for use by healthcare staff. Journal of Human Nutrition and Dietetics: The Official Journal of the British Dietetic Association. 2012; 25:311-318.
      • 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.
      • Moeeni V, Walls T, Day A. The STRONGkids nutritional risk screening tool can be used by paediatric nurses to identify hospitalised children at risk. Acta Paediatrica (Oslo, Norway: 1992). 2014; 103:e528-531.
      • Wong S, Graham A, Hirani S, Grimble G, Forbes A. Validation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) in patients with spinal cord injuries (SCIs). Spinal Cord. 2013; 51:424-429.
  • Search Plan and Results: NSP: Validity and Reliability of Pediatric Screening Tools 2017