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Skye Marshall Adrienne Young Elizabeth Isenring 《Journal of the Academy of Nutrition and Dietetics》2018,118(1):118-124
Background
The validity of the Malnutrition Screening Tool (MST) in geriatric rehabilitation has been evaluated in a research environment but not in professional practice.Objective
In older adults admitted to rehabilitation, this study was undertaken to compare the MST scoring agreement (inter-rater reliability) between health professionals with and without malnutrition risk and screening training; to evaluate the concurrent validity of the MST completed by the trained and untrained health professionals compared to the International Classification of Diseases, Tenth Revision, Australian Modification using different MST score cutoffs; and to determine whether patient characteristics were associated with MST scoring accuracy when completed by health professionals without malnutrition risk and screening training.Design
This was an observational, cross-sectional study.Participants/setting
Fifty-seven older adults (mean age=79.1±7.3 years) were recruited from August 2013 to February 2014 from two rural rehabilitation units in New South Wales, Australia.Main outcome measures
MST, International Classification of Diseases, Tenth Revision, Australian Modification, classification of malnutrition, and patient characteristics were used to measure outcomes.Statistical analysis performed
Measures of diagnostic accuracy generated from a contingency table, receiver operating characteristic curve, and Spearman’s correlation were used.Results
The MST scores completed by health professionals with and without malnutrition risk and screening training showed moderate correlation and fair agreement (rs=0.465; P=0.001; κ=0.297; P=0.028). When compared to the International Classification of Diseases, Tenth Revision, Australian Modification, the untrained MST administration showed moderate diagnostic accuracy (sensitivity 56.5%, specificity 83.3%), but increasing the MST score to ≥3 caused the sensitivity of both the trained and untrained MST administration to decrease (56.5% and 22.9%, respectively).Conclusions
The application of the MST by health professionals without malnutrition risk and screening training in rehabilitation may not provide sufficient accuracy in identifying patients with malnutrition risk. Using an MST score of ≥2 to indicate malnutrition risk is recommended, as increasing the MST cutoff score to ≥3 is likely to have insufficient accuracy, even when completed by health professionals with malnutrition risk and screening training. Research evaluating the impact of providing rehabilitation staff with regular and ongoing training in completing malnutrition screening and referral pathways is warranted. 相似文献2.
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Jessica Steenson Angela Vivanti Elizabeth Isenring 《Nutrition (Burbank, Los Angeles County, Calif.)》2013,29(1):350-352
ObjectivesMalnutrition continues to be under-recognized and undertreated in the hospitalized setting. Although no “gold standard” for the diagnosis of malnutrition exists, the Subjective Global Assessment (SGA) is a commonly used malnutrition assessment tool. The study aim was to explore the reporting of inter-rater reliability (IRR) of the SGA when used as a nutritional assessment tool in the published literature.MethodsA comprehensive literature review was performed identifying 119 articles using the SGA once exclusion criteria were applied. Articles were examined for use of IRR and the Cohen κ agreement between examiners.ResultsThe IRR of the SGA was reported in only 13% of articles where the SGA was used for nutritional assessment. The κ agreement was highest when examiners were experienced.ConclusionsThe IRR is rarely reported in the published literature and has not yet been reported across experience levels. 相似文献
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The hormonal regulation of sodium and volume homeostasis was investigated in three patients (two related) with the syndrome of familial hyperkalemic acidosis and hypertension with normal glomerular filtration rate. Recumbent plasma renin activity was low during normal sodium intake (135 mmol daily), and the response to upright posture or to low sodium diet (10 mmol daily) was blunted. Recumbent plasma aldosterone levels were normal in two patients and high in one, and the standing values were elevated in one; responses to upright posture were brisk on low sodium diet. Angiotensin II infusion induced a marked increase in plasma aldosterone. Plasma atrial natriuretic peptide was at the upper limit of normal during normal sodium intake, decreased during diuretic therapy, and increased during sodium chloride infusion in one patient. Basal urinary prostaglandin E2, prostaglandin F2 alpha, and 6-ketoprostaglandin F1 alpha excretion rates were decreased, and thromboxane B2 was increased. Total blood and plasma volumes were subnormal, whereas extracellular fluid volume and exchangeable sodium values were close to or above (in one patient) the mean normal values. Chronic treatment with hydrochlorothiazide in two patients corrected the hyperkalemic acidosis and hypertension, but on its discontinuation (in one patient) all biochemical abnormalities promptly reappeared. 相似文献
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Garneau Alexandre P. Haydock Ludwig Tremblay Laurence E. Harvey-Michaud Pierre-Luc Hsiao Yun-Hua Esther Strom Samuel P. Canaud Guillaume Isenring Paul 《Journal of molecular medicine (Berlin, Germany)》2022,100(7):1087-1090
Journal of Molecular Medicine - 相似文献
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Favorable outcome of children and adolescents undergoing lung transplantation at a European adult center in the new era 
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