Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial

. Objective: Nutritional evaluation of cancer patients may lead to treatment intervention that reduces morbidity and mortality. This evaluation can be done subjectively or objectively. We studied the correlation between subjective and objective nutritional assessment in gynecological oncology patien...

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Veröffentlicht in:International journal of gynecological cancer 2004-03, Vol.14 (2), p.220-223
Hauptverfasser: Santoso, J. T., Cannada, T., O'Farrel, B., Alladi, K., Coleman, R. L.
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container_end_page 223
container_issue 2
container_start_page 220
container_title International journal of gynecological cancer
container_volume 14
creator Santoso, J. T.
Cannada, T.
O'Farrel, B.
Alladi, K.
Coleman, R. L.
description . Objective: Nutritional evaluation of cancer patients may lead to treatment intervention that reduces morbidity and mortality. This evaluation can be done subjectively or objectively. We studied the correlation between subjective and objective nutritional assessment in gynecological oncology patients. Methods: Sixty‐seven consecutive patients admitted to the gynecological oncology service were prospectively evaluated by laboratory criteria using a standardized formula. The prognostic nutritional index (PNI) consists of tests measuring albumin, transferrin, triceps skin fold, and skin sensitivity reaction to common antigens. The patients were also subjectively evaluated using a standardized questionnaire and physical examination, known as the subjective global assessment, by two clinicians who were blinded from the PNI results. Both scores were categorized as normal, mild malnutrition, or severe malnutrition. Reproducibility of the subjective testers and consistency between the subjective and the objective evaluations were assessed with a weighted kappa statistic. Results: Cancer distribution consisted of 39 (58%) cervical, 16 (24%) endometrial, 11 (16%) ovarian, and one (2%) vulvar carcinomas. There was a high level of agreement between the two subjective raters (weighted kappa = 0.797; 95% CI 0.67–0.92). Furthermore, there were no cases in which the ratings differed by two points on the three‐point ordered scale of nutritional status. Agreement between the two evaluation methods was only fair to moderate (weighted kappa = 0.435; 95% CI 0.28–0.59). Agreement was exact in 38 of 67 patients (57%). There were eight patients (12%) where the difference in ratings differed by two points on the ordinal scale, all with the subjective scored as normal, but the objective rated as severe malnourishment. Conclusion: In assessing nutritional status of gynecological patients, subjective assessment differs with objective/laboratory measurement.
doi_str_mv 10.1111/j.1048-891X.2004.014203.x
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T. ; Cannada, T. ; O'Farrel, B. ; Alladi, K. ; Coleman, R. L.</creator><creatorcontrib>Santoso, J. T. ; Cannada, T. ; O'Farrel, B. ; Alladi, K. ; Coleman, R. L.</creatorcontrib><description>. Objective: Nutritional evaluation of cancer patients may lead to treatment intervention that reduces morbidity and mortality. This evaluation can be done subjectively or objectively. We studied the correlation between subjective and objective nutritional assessment in gynecological oncology patients. Methods: Sixty‐seven consecutive patients admitted to the gynecological oncology service were prospectively evaluated by laboratory criteria using a standardized formula. The prognostic nutritional index (PNI) consists of tests measuring albumin, transferrin, triceps skin fold, and skin sensitivity reaction to common antigens. The patients were also subjectively evaluated using a standardized questionnaire and physical examination, known as the subjective global assessment, by two clinicians who were blinded from the PNI results. Both scores were categorized as normal, mild malnutrition, or severe malnutrition. Reproducibility of the subjective testers and consistency between the subjective and the objective evaluations were assessed with a weighted kappa statistic. Results: Cancer distribution consisted of 39 (58%) cervical, 16 (24%) endometrial, 11 (16%) ovarian, and one (2%) vulvar carcinomas. There was a high level of agreement between the two subjective raters (weighted kappa = 0.797; 95% CI 0.67–0.92). Furthermore, there were no cases in which the ratings differed by two points on the three‐point ordered scale of nutritional status. Agreement between the two evaluation methods was only fair to moderate (weighted kappa = 0.435; 95% CI 0.28–0.59). Agreement was exact in 38 of 67 patients (57%). There were eight patients (12%) where the difference in ratings differed by two points on the ordinal scale, all with the subjective scored as normal, but the objective rated as severe malnourishment. Conclusion: In assessing nutritional status of gynecological patients, subjective assessment differs with objective/laboratory measurement.</description><identifier>ISSN: 1048-891X</identifier><identifier>EISSN: 1525-1438</identifier><identifier>DOI: 10.1111/j.1048-891X.2004.014203.x</identifier><identifier>PMID: 15086719</identifier><language>eng</language><publisher>Oxford, UK; Malden, USA: Blackwell Science Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Genital Neoplasms, Female - complications ; gynecological cancer ; Humans ; Middle Aged ; Nutrition Assessment ; Nutrition Disorders - complications ; Nutrition Disorders - diagnosis ; nutritional assessments ; Nutritional Status ; Observer Variation ; Prospective Studies ; Reproducibility of Results ; Skinfold Thickness</subject><ispartof>International journal of gynecological cancer, 2004-03, Vol.14 (2), p.220-223</ispartof><rights>Copyright © 2004 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4146-67fdaba4220e484e482dd34a57dc948df51a6754d833b9f67c1cb703c19745ac3</citedby><cites>FETCH-LOGICAL-c4146-67fdaba4220e484e482dd34a57dc948df51a6754d833b9f67c1cb703c19745ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1048-891X.2004.014203.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1048-891X.2004.014203.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15086719$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Santoso, J. T.</creatorcontrib><creatorcontrib>Cannada, T.</creatorcontrib><creatorcontrib>O'Farrel, B.</creatorcontrib><creatorcontrib>Alladi, K.</creatorcontrib><creatorcontrib>Coleman, R. L.</creatorcontrib><title>Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial</title><title>International journal of gynecological cancer</title><addtitle>Int J Gynecol Cancer</addtitle><description>. Objective: Nutritional evaluation of cancer patients may lead to treatment intervention that reduces morbidity and mortality. This evaluation can be done subjectively or objectively. We studied the correlation between subjective and objective nutritional assessment in gynecological oncology patients. Methods: Sixty‐seven consecutive patients admitted to the gynecological oncology service were prospectively evaluated by laboratory criteria using a standardized formula. The prognostic nutritional index (PNI) consists of tests measuring albumin, transferrin, triceps skin fold, and skin sensitivity reaction to common antigens. The patients were also subjectively evaluated using a standardized questionnaire and physical examination, known as the subjective global assessment, by two clinicians who were blinded from the PNI results. Both scores were categorized as normal, mild malnutrition, or severe malnutrition. Reproducibility of the subjective testers and consistency between the subjective and the objective evaluations were assessed with a weighted kappa statistic. Results: Cancer distribution consisted of 39 (58%) cervical, 16 (24%) endometrial, 11 (16%) ovarian, and one (2%) vulvar carcinomas. There was a high level of agreement between the two subjective raters (weighted kappa = 0.797; 95% CI 0.67–0.92). Furthermore, there were no cases in which the ratings differed by two points on the three‐point ordered scale of nutritional status. Agreement between the two evaluation methods was only fair to moderate (weighted kappa = 0.435; 95% CI 0.28–0.59). Agreement was exact in 38 of 67 patients (57%). There were eight patients (12%) where the difference in ratings differed by two points on the ordinal scale, all with the subjective scored as normal, but the objective rated as severe malnourishment. Conclusion: In assessing nutritional status of gynecological patients, subjective assessment differs with objective/laboratory measurement.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Genital Neoplasms, Female - complications</subject><subject>gynecological cancer</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Nutrition Assessment</subject><subject>Nutrition Disorders - complications</subject><subject>Nutrition Disorders - diagnosis</subject><subject>nutritional assessments</subject><subject>Nutritional Status</subject><subject>Observer Variation</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Skinfold Thickness</subject><issn>1048-891X</issn><issn>1525-1438</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcFu1DAUtBCIlpZfQObCLcGOnTjmglBVSqtKHACpN8txXrpevPFiO03373HYUK5Ysvze08y80Riht5SUNJ_325IS3hatpHdlRQgvCeUVYeXjM3RK66ouKGft81z_RZ2gVzFuCSGyIvIlOqE1aRtB5Smav03dFkyyD4AfIMQpYv80GKcUbLJ-1A7rGCHGHYwJxzT1B2xHPPvc49mmDb4_jGC88_fWZLDRo4HwAWu8Dz7uVznjNz4knDW1O0cvBu0ivF7fM_Tj8-X3iy_F7der64tPt4XhlDdFI4Zed5pXFQHe8nyrvmdc16I3krf9UFPdiJr3LWOdHBphqOkEYYZKwWtt2Bl6d9TNRn5NEJPa2WjAOT2Cn6ISNDMr2WSgPAJNdhwDDGof7E6Hg6JELamrrVryVEueakldHVNXj5n7Zl0ydTvo_zHXmDOAHwGzdymn_NNNMwS1Ae3SRpHlY2ohikWVsNwVy2jx9HGlWQeH_zekrm-u_pTsN2e3pCo</recordid><startdate>200403</startdate><enddate>200403</enddate><creator>Santoso, J. T.</creator><creator>Cannada, T.</creator><creator>O'Farrel, B.</creator><creator>Alladi, K.</creator><creator>Coleman, R. L.</creator><general>Blackwell Science Inc</general><general>Copyright Blackwell Publishing Ltd</general><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></search><sort><creationdate>200403</creationdate><title>Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial</title><author>Santoso, J. T. ; Cannada, T. ; O'Farrel, B. ; Alladi, K. ; Coleman, R. 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T.</creatorcontrib><creatorcontrib>Cannada, T.</creatorcontrib><creatorcontrib>O'Farrel, B.</creatorcontrib><creatorcontrib>Alladi, K.</creatorcontrib><creatorcontrib>Coleman, R. L.</creatorcontrib><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>International journal of gynecological cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Santoso, J. T.</au><au>Cannada, T.</au><au>O'Farrel, B.</au><au>Alladi, K.</au><au>Coleman, R. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial</atitle><jtitle>International journal of gynecological cancer</jtitle><addtitle>Int J Gynecol Cancer</addtitle><date>2004-03</date><risdate>2004</risdate><volume>14</volume><issue>2</issue><spage>220</spage><epage>223</epage><pages>220-223</pages><issn>1048-891X</issn><eissn>1525-1438</eissn><abstract>. Objective: Nutritional evaluation of cancer patients may lead to treatment intervention that reduces morbidity and mortality. This evaluation can be done subjectively or objectively. We studied the correlation between subjective and objective nutritional assessment in gynecological oncology patients. Methods: Sixty‐seven consecutive patients admitted to the gynecological oncology service were prospectively evaluated by laboratory criteria using a standardized formula. The prognostic nutritional index (PNI) consists of tests measuring albumin, transferrin, triceps skin fold, and skin sensitivity reaction to common antigens. The patients were also subjectively evaluated using a standardized questionnaire and physical examination, known as the subjective global assessment, by two clinicians who were blinded from the PNI results. Both scores were categorized as normal, mild malnutrition, or severe malnutrition. Reproducibility of the subjective testers and consistency between the subjective and the objective evaluations were assessed with a weighted kappa statistic. Results: Cancer distribution consisted of 39 (58%) cervical, 16 (24%) endometrial, 11 (16%) ovarian, and one (2%) vulvar carcinomas. There was a high level of agreement between the two subjective raters (weighted kappa = 0.797; 95% CI 0.67–0.92). Furthermore, there were no cases in which the ratings differed by two points on the three‐point ordered scale of nutritional status. Agreement between the two evaluation methods was only fair to moderate (weighted kappa = 0.435; 95% CI 0.28–0.59). Agreement was exact in 38 of 67 patients (57%). There were eight patients (12%) where the difference in ratings differed by two points on the ordinal scale, all with the subjective scored as normal, but the objective rated as severe malnourishment. Conclusion: In assessing nutritional status of gynecological patients, subjective assessment differs with objective/laboratory measurement.</abstract><cop>Oxford, UK; Malden, USA</cop><pub>Blackwell Science Inc</pub><pmid>15086719</pmid><doi>10.1111/j.1048-891X.2004.014203.x</doi><tpages>4</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Genital Neoplasms, Female - complications
gynecological cancer
Humans
Middle Aged
Nutrition Assessment
Nutrition Disorders - complications
Nutrition Disorders - diagnosis
nutritional assessments
Nutritional Status
Observer Variation
Prospective Studies
Reproducibility of Results
Skinfold Thickness
title Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial
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