目的:营养不良是胃肠道(GI)癌症的重要问题,准确的筛查和识别对于确保适当的营养干预至关重要。本研究旨在确定目前的证据,证明营养不良筛查工具在胃肠道癌症中的同时有效性。
方法:根据PRISMA指南进行了系统评价,使用四个数据库。确定了针对成人胃肠道癌症患者的患者生成主观整体评估(PG-SGA)或主观整体评估(SGA)参考标准的营养不良筛查工具的并发有效性的研究。筛选,使用QUADAS-2检查表进行质量评估,和数据提取由两名独立的审阅者进行。使用预定义的标准应用并发有效性评级。
结果:六项研究调查了营养风险指数(NRI)的并发有效性,营养不良通用筛查工具(必须),包括营养不良筛查工具(MST)和2002年营养风险筛查标准(NRS-2002)。并发有效性评级存在差异,从所有工具的不良-良好,根据治疗类型,阶段和人口特征。
结论:无法提出关于使用一种工具而不是另一种工具的建议。然而,在缺乏针对胃肠道癌症的明确建议的情况下,应使用在一般临床人群中得到充分验证的筛查工具。可以基于针对来自其他肿瘤学群体的PG-SGA和SGA的有效性数据来推荐MST。如果指示,营养不良筛查后,应进行全面的营养评估.
OBJECTIVE: Malnutrition is a significant problem in gastrointestinal (GI) cancer, and accurate screening and identification is essential to ensure appropriate nutrition intervention. This study aims to determine current evidence for concurrent validity of malnutrition screening tools in GI cancer.
METHODS: A systematic
review was undertaken according to PRISMA guidelines, using four databases. Studies investigating the concurrent validity of malnutrition screening tools against a reference standard of Patient Generated Subjective Global Assessment (PG-SGA) or Subjective Global Assessment (SGA) in adult patients with GI cancer were identified. Screening, quality assessment using the QUADAS-2 checklist, and data extraction were performed by two independent reviewers. Concurrent validity ratings were applied using predefined criteria.
RESULTS: Six studies investigating concurrent validity of the Nutrition Risk Index (NRI), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST) and Nutrition Risk Screening 2002 criteria (NRS-2002) were included. There was variation in concurrent validity ratings ranging from poor-good for all tools, depending on treatment type, stage and population characteristics.
CONCLUSIONS: Recommendations regarding the use of one tool over another could not be made. However, in the absence of a clear recommendation specific to GI cancer, screening tools that are well validated in general clinical populations should be utilised. The MST can be recommended based on validity data against the PG-SGA and SGA from other oncology populations. If indicated, malnutrition screening should then be followed by thorough nutritional assessment.