Part of a presentation given at the Canadian Nutrition Society Conference Manon Laporte PDt, MSc June 2013

Validated Nutrition Screening Tools (for hospital use)  Simple Screening Tools (# 1 & # 2)  Malnutrition Screening Tool (MST)  Mini Nutritional Assessment – Short Form (MNA-SF)  Nutritional Risk Screening 2002 (NRS 2002)  Malnutrition Universal Screening Tool (MUST)  Short Nutritional Assessment Questionnaire (SNAQ)

Screening Tools ParametersCriterion Validity Weight loss BMI Appetite/ Food intake Others Gold Standard SensitivitySpecificity Simple Screening tools 1998 #1 #2 Albumin In-depth assessment by dietitians (2 studies) 75% 92% 75% 69% MST 1999 SGA (4 studies) 74%-93%76%-93% MNA-SF © 2001 Psycho. stress Acute disease Neuropsycho. problems Mobility - Dietitian assessment - SGA - Full MNA (4 studies) 93% 100% 64%-96% 38% 52.8% 89%-100% NRS 2002 Severity of disease SGA (5 studies) 62% - 90%83.3%-93% MUST 2003 Acutely ill SGA (4 studies) 61%-87.1%78.6%-93% SNAQ © 2005 Use of : Supplemental drinks or Tube feeding % Weight loss & BMI SGA (2012) 79% 83% 90.3%

Screening Tools Reliability (inter-rater) Kappa Score Simple / Easy to use? Limits Screening Tools 1998 # 1 # ± Calculation of % weight loss Laboratory parameter MST – 0.93Yes Eating poorly: only because  appetite & No time frame of eating poorly Validity 93% - developmental study MNA-SF © 2001 Not reportedNo Low specificity For elderly population only Too comprehensive NRS No Low sensitivity Too detailed (% of food intake and weight loss) MUST 2003Not reported± Calculation of % weight loss in specific time frames Same BMI range for adult and elderly populations SNAQ © – 0.91± Yes No acceptable reference standard (EAL-ADA 2011) Decrease appetite over the last month…