目标:挪威卫生局已确定有必要协调和规范挪威医院和初级卫生保健机构的营养不良筛查做法,以便沿着患者路径提供营养不良筛查的无缝沟通。我们的目的是对用于识别卫生保健机构营养不良风险的筛查工具的有效性和可靠性进行系统审查。诊断或条件和成人年龄组,作为迈向国家推荐一种筛查工具的第一步。
方法:对评价有效性的文章进行系统的文献检索,协议,以及营养不良筛查工具的可靠性,截至2020年8月,在以下网站进行:MEDLINE,Embase,APAPsycInfo,Cinahl,Cochrane数据库,WebofScience,认识论,SveMed+,还有Norart.系统评价在PROSPERO(CRD42022300558)中注册。对于每一篇文章的批判性评估,使用了营养与饮食学会的质量标准清单。
结果:该综述确定了105篇符合纳入和排除标准的文章。最常用的验证工具是迷你营养评估简表(MNA),营养不良通用筛查工具(必须),营养不良筛查工具(MST),和营养风险筛查2002(NRS-2002)。MNA,MST和NRS-2002显示总体中等有效性,必须低有效性。所有四个工具都显示出低一致性。MST和MUST在医疗保健环境和年龄组进行了验证。总的来说,可靠性数据有限。
结论:筛选工具MST和NRS-2002对成人营养不良的识别显示出中等有效性,其中MST在整个医疗保健环境中得到验证。此外,MNA对于确定65岁或65岁以上的成年人营养不良具有中等有效性。
The Norwegian Directorate of Health has identified a need to harmonize and standardize the malnutrition screening practice in Norwegian hospitals and primary health care settings, in order to provide a seamless communication of malnutrition screening along the patient pathway. Our aim was to perform a systematic review of the validity and reliability of screening tools used to identify risk of malnutrition across health care settings, diagnoses or conditions and adult age groups, as a first step towards a national recommendation of one screening tool.
A systematic literature search for articles evaluating validity, agreement, and reliability of malnutrition screening tools, published up to August 2020, was conducted in: MEDLINE, Embase, APA PsycInfo, Cinahl, Cochrane Databases, Web of Science, Epistemonikos, SveMed+, and Norart. The systematic review was registered in PROSPERO (CRD42022300558). For critical appraisal of each included article, the Quality Criteria Checklist by The Academy of Nutrition and Dietetics was used.
The review identified 105 articles that fulfilled the inclusion and exclusion criteria. The most frequently validated tools were Mini Nutritional Assessment short form (MNA), Malnutrition Universal Screening Tool (
MUST), Malnutrition Screening Tool (MST), and Nutritional Risk Screening 2002 (NRS-2002). MNA, MST and NRS-2002 displayed overall moderate validity, and
MUST low validity. All four tools displayed low agreement. MST and
MUST were validated across health care settings and age groups. In general, data on reliability was limited.
The screening tools MST and NRS-2002 displayed moderate validity for the identification of malnutrition in adults, of which MST is validated across health care settings. In addition, MNA has moderate validity for the identification of malnutrition in adults 65 years or older.