Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations
Background Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use. Methods Studies identified by a systematic review assessed the general validity of screenin...
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| Veröffentlicht in: | JPEN. Journal of parenteral and enteral nutrition 2024-11, Vol.48 (8), p.874-894 |
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| container_title | JPEN. Journal of parenteral and enteral nutrition |
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| creator | Trujillo, Elaine B. Kadakia, Kunal C. Thomson, Cynthia Zhang, Fang Fang Livinski, Alicia Pollard, Kim Mattox, Todd Tucker, Anne Williams, Valaree Walsh, Declan Clinton, Steven Grossberg, Aaron Jensen, Gordon Levin, Rhone Mills, Jeannine Singh, Anurag Smith, Meredith Stubbins, Renee Wiley, Kathleen Sullivan, Kristen Platek, Mary Spees, Colleen K. |
| description | Background
Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.
Methods
Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?
Results
Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut‐points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient‐led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening‐2002 (NRS‐2002; NRS‐2002 ≥ 2 and NRS‐2002 ≥ 3), NUTRISCORE ≥ 5, and Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF; PG‐SGA SF ≥ 7 and PG‐SGA SF ≥ 8).
Conclusion
Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients. |
| doi_str_mv | 10.1002/jpen.2688 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3117079326</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3117079326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2508-89677a476c52d0308ae96f157504459791efaeee620e06a5585c0195f719ce243</originalsourceid><addsrcrecordid>eNp1kM1O3DAURi1UBFPKoi9QeVkWgWvHPzG7EaKlFdBKbdeRcW6QwbEHOwHN2zfDADtWV_p0dK50CPnM4JgB8JO7FcZjrppmhyyYEaziQogPZAFMNJUCzfbJx1LuAKBWAHtkv54hDkYvSL6yIU5j9qNPkWZf7mlxGTH6eEt9pLabwkhTdCmk2zVN07iyo8c4llO6jHT55_f5NS3rMuIw745mfPT4RG3sqAs-emfDvLk0DBg7u3lSPpHd3oaChy_3gPz7dv737KK6_PX9x9nysnJcQlM1RmlthVZO8g5qaCwa1TOpJQghjTYMe4uIigOCslI20gEzstfMOOSiPiBft95VTg8TlrEdfHEYgo2YptLWjGnQpuZqRo-2qMuplIx9u8p-sHndMmg3idtN4naTeGa_vGinmwG7N_K16QycbIEnH3D9vqn9Obd7Vv4H6cuHAg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3117079326</pqid></control><display><type>article</type><title>Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Trujillo, Elaine B. ; Kadakia, Kunal C. ; Thomson, Cynthia ; Zhang, Fang Fang ; Livinski, Alicia ; Pollard, Kim ; Mattox, Todd ; Tucker, Anne ; Williams, Valaree ; Walsh, Declan ; Clinton, Steven ; Grossberg, Aaron ; Jensen, Gordon ; Levin, Rhone ; Mills, Jeannine ; Singh, Anurag ; Smith, Meredith ; Stubbins, Renee ; Wiley, Kathleen ; Sullivan, Kristen ; Platek, Mary ; Spees, Colleen K.</creator><creatorcontrib>Trujillo, Elaine B. ; Kadakia, Kunal C. ; Thomson, Cynthia ; Zhang, Fang Fang ; Livinski, Alicia ; Pollard, Kim ; Mattox, Todd ; Tucker, Anne ; Williams, Valaree ; Walsh, Declan ; Clinton, Steven ; Grossberg, Aaron ; Jensen, Gordon ; Levin, Rhone ; Mills, Jeannine ; Singh, Anurag ; Smith, Meredith ; Stubbins, Renee ; Wiley, Kathleen ; Sullivan, Kristen ; Platek, Mary ; Spees, Colleen K.</creatorcontrib><description>Background
Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.
Methods
Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?
Results
Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut‐points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient‐led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening‐2002 (NRS‐2002; NRS‐2002 ≥ 2 and NRS‐2002 ≥ 3), NUTRISCORE ≥ 5, and Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF; PG‐SGA SF ≥ 7 and PG‐SGA SF ≥ 8).
Conclusion
Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.</description><identifier>ISSN: 0148-6071</identifier><identifier>ISSN: 1941-2444</identifier><identifier>EISSN: 1941-2444</identifier><identifier>DOI: 10.1002/jpen.2688</identifier><identifier>PMID: 39412097</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Humans ; Malnutrition - diagnosis ; Malnutrition - etiology ; Mass Screening - methods ; Neoplasms - complications ; nutrition ; Nutrition Assessment ; Nutritional Status ; oncology ; Outpatients ; research and diseases ; Risk Assessment - methods ; Risk Factors ; weight loss</subject><ispartof>JPEN. Journal of parenteral and enteral nutrition, 2024-11, Vol.48 (8), p.874-894</ispartof><rights>2024 The Author(s). published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.</rights><rights>2024 The Author(s). Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2508-89677a476c52d0308ae96f157504459791efaeee620e06a5585c0195f719ce243</cites><orcidid>0000-0003-4690-4948 ; 0000-0003-3431-0106 ; 0000-0001-5223-7622 ; 0000-0002-8480-2427</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjpen.2688$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjpen.2688$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39412097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trujillo, Elaine B.</creatorcontrib><creatorcontrib>Kadakia, Kunal C.</creatorcontrib><creatorcontrib>Thomson, Cynthia</creatorcontrib><creatorcontrib>Zhang, Fang Fang</creatorcontrib><creatorcontrib>Livinski, Alicia</creatorcontrib><creatorcontrib>Pollard, Kim</creatorcontrib><creatorcontrib>Mattox, Todd</creatorcontrib><creatorcontrib>Tucker, Anne</creatorcontrib><creatorcontrib>Williams, Valaree</creatorcontrib><creatorcontrib>Walsh, Declan</creatorcontrib><creatorcontrib>Clinton, Steven</creatorcontrib><creatorcontrib>Grossberg, Aaron</creatorcontrib><creatorcontrib>Jensen, Gordon</creatorcontrib><creatorcontrib>Levin, Rhone</creatorcontrib><creatorcontrib>Mills, Jeannine</creatorcontrib><creatorcontrib>Singh, Anurag</creatorcontrib><creatorcontrib>Smith, Meredith</creatorcontrib><creatorcontrib>Stubbins, Renee</creatorcontrib><creatorcontrib>Wiley, Kathleen</creatorcontrib><creatorcontrib>Sullivan, Kristen</creatorcontrib><creatorcontrib>Platek, Mary</creatorcontrib><creatorcontrib>Spees, Colleen K.</creatorcontrib><title>Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations</title><title>JPEN. Journal of parenteral and enteral nutrition</title><addtitle>JPEN J Parenter Enteral Nutr</addtitle><description>Background
Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.
Methods
Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?
Results
Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut‐points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient‐led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening‐2002 (NRS‐2002; NRS‐2002 ≥ 2 and NRS‐2002 ≥ 3), NUTRISCORE ≥ 5, and Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF; PG‐SGA SF ≥ 7 and PG‐SGA SF ≥ 8).
Conclusion
Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.</description><subject>Adult</subject><subject>Humans</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - etiology</subject><subject>Mass Screening - methods</subject><subject>Neoplasms - complications</subject><subject>nutrition</subject><subject>Nutrition Assessment</subject><subject>Nutritional Status</subject><subject>oncology</subject><subject>Outpatients</subject><subject>research and diseases</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>weight loss</subject><issn>0148-6071</issn><issn>1941-2444</issn><issn>1941-2444</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kM1O3DAURi1UBFPKoi9QeVkWgWvHPzG7EaKlFdBKbdeRcW6QwbEHOwHN2zfDADtWV_p0dK50CPnM4JgB8JO7FcZjrppmhyyYEaziQogPZAFMNJUCzfbJx1LuAKBWAHtkv54hDkYvSL6yIU5j9qNPkWZf7mlxGTH6eEt9pLabwkhTdCmk2zVN07iyo8c4llO6jHT55_f5NS3rMuIw745mfPT4RG3sqAs-emfDvLk0DBg7u3lSPpHd3oaChy_3gPz7dv737KK6_PX9x9nysnJcQlM1RmlthVZO8g5qaCwa1TOpJQghjTYMe4uIigOCslI20gEzstfMOOSiPiBft95VTg8TlrEdfHEYgo2YptLWjGnQpuZqRo-2qMuplIx9u8p-sHndMmg3idtN4naTeGa_vGinmwG7N_K16QycbIEnH3D9vqn9Obd7Vv4H6cuHAg</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Trujillo, Elaine B.</creator><creator>Kadakia, Kunal C.</creator><creator>Thomson, Cynthia</creator><creator>Zhang, Fang Fang</creator><creator>Livinski, Alicia</creator><creator>Pollard, Kim</creator><creator>Mattox, Todd</creator><creator>Tucker, Anne</creator><creator>Williams, Valaree</creator><creator>Walsh, Declan</creator><creator>Clinton, Steven</creator><creator>Grossberg, Aaron</creator><creator>Jensen, Gordon</creator><creator>Levin, Rhone</creator><creator>Mills, Jeannine</creator><creator>Singh, Anurag</creator><creator>Smith, Meredith</creator><creator>Stubbins, Renee</creator><creator>Wiley, Kathleen</creator><creator>Sullivan, Kristen</creator><creator>Platek, Mary</creator><creator>Spees, Colleen K.</creator><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4690-4948</orcidid><orcidid>https://orcid.org/0000-0003-3431-0106</orcidid><orcidid>https://orcid.org/0000-0001-5223-7622</orcidid><orcidid>https://orcid.org/0000-0002-8480-2427</orcidid></search><sort><creationdate>202411</creationdate><title>Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations</title><author>Trujillo, Elaine B. ; Kadakia, Kunal C. ; Thomson, Cynthia ; Zhang, Fang Fang ; Livinski, Alicia ; Pollard, Kim ; Mattox, Todd ; Tucker, Anne ; Williams, Valaree ; Walsh, Declan ; Clinton, Steven ; Grossberg, Aaron ; Jensen, Gordon ; Levin, Rhone ; Mills, Jeannine ; Singh, Anurag ; Smith, Meredith ; Stubbins, Renee ; Wiley, Kathleen ; Sullivan, Kristen ; Platek, Mary ; Spees, Colleen K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2508-89677a476c52d0308ae96f157504459791efaeee620e06a5585c0195f719ce243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Humans</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - etiology</topic><topic>Mass Screening - methods</topic><topic>Neoplasms - complications</topic><topic>nutrition</topic><topic>Nutrition Assessment</topic><topic>Nutritional Status</topic><topic>oncology</topic><topic>Outpatients</topic><topic>research and diseases</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>weight loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trujillo, Elaine B.</creatorcontrib><creatorcontrib>Kadakia, Kunal C.</creatorcontrib><creatorcontrib>Thomson, Cynthia</creatorcontrib><creatorcontrib>Zhang, Fang Fang</creatorcontrib><creatorcontrib>Livinski, Alicia</creatorcontrib><creatorcontrib>Pollard, Kim</creatorcontrib><creatorcontrib>Mattox, Todd</creatorcontrib><creatorcontrib>Tucker, Anne</creatorcontrib><creatorcontrib>Williams, Valaree</creatorcontrib><creatorcontrib>Walsh, Declan</creatorcontrib><creatorcontrib>Clinton, Steven</creatorcontrib><creatorcontrib>Grossberg, Aaron</creatorcontrib><creatorcontrib>Jensen, Gordon</creatorcontrib><creatorcontrib>Levin, Rhone</creatorcontrib><creatorcontrib>Mills, Jeannine</creatorcontrib><creatorcontrib>Singh, Anurag</creatorcontrib><creatorcontrib>Smith, Meredith</creatorcontrib><creatorcontrib>Stubbins, Renee</creatorcontrib><creatorcontrib>Wiley, Kathleen</creatorcontrib><creatorcontrib>Sullivan, Kristen</creatorcontrib><creatorcontrib>Platek, Mary</creatorcontrib><creatorcontrib>Spees, Colleen K.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JPEN. Journal of parenteral and enteral nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trujillo, Elaine B.</au><au>Kadakia, Kunal C.</au><au>Thomson, Cynthia</au><au>Zhang, Fang Fang</au><au>Livinski, Alicia</au><au>Pollard, Kim</au><au>Mattox, Todd</au><au>Tucker, Anne</au><au>Williams, Valaree</au><au>Walsh, Declan</au><au>Clinton, Steven</au><au>Grossberg, Aaron</au><au>Jensen, Gordon</au><au>Levin, Rhone</au><au>Mills, Jeannine</au><au>Singh, Anurag</au><au>Smith, Meredith</au><au>Stubbins, Renee</au><au>Wiley, Kathleen</au><au>Sullivan, Kristen</au><au>Platek, Mary</au><au>Spees, Colleen K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations</atitle><jtitle>JPEN. Journal of parenteral and enteral nutrition</jtitle><addtitle>JPEN J Parenter Enteral Nutr</addtitle><date>2024-11</date><risdate>2024</risdate><volume>48</volume><issue>8</issue><spage>874</spage><epage>894</epage><pages>874-894</pages><issn>0148-6071</issn><issn>1941-2444</issn><eissn>1941-2444</eissn><abstract>Background
Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.
Methods
Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?
Results
Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut‐points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient‐led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening‐2002 (NRS‐2002; NRS‐2002 ≥ 2 and NRS‐2002 ≥ 3), NUTRISCORE ≥ 5, and Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF; PG‐SGA SF ≥ 7 and PG‐SGA SF ≥ 8).
Conclusion
Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.</abstract><cop>United States</cop><pmid>39412097</pmid><doi>10.1002/jpen.2688</doi><tpages>21</tpages><orcidid>https://orcid.org/0000-0003-4690-4948</orcidid><orcidid>https://orcid.org/0000-0003-3431-0106</orcidid><orcidid>https://orcid.org/0000-0001-5223-7622</orcidid><orcidid>https://orcid.org/0000-0002-8480-2427</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0148-6071 |
| ispartof | JPEN. Journal of parenteral and enteral nutrition, 2024-11, Vol.48 (8), p.874-894 |
| issn | 0148-6071 1941-2444 1941-2444 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Humans Malnutrition - diagnosis Malnutrition - etiology Mass Screening - methods Neoplasms - complications nutrition Nutrition Assessment Nutritional Status oncology Outpatients research and diseases Risk Assessment - methods Risk Factors weight loss |
| title | Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations |
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