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Background: Several malnutrition screening tools have been advocated for use in pediatric inpatients. Objective: We evaluated how 3 popular pediatric nutrition screening tools [i.e., the Pediatric Yorkhill Malnutrition Score (PYMS), the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and the Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONG KIDS )] compared with and were related to anthropometric measures, body composition, and clinical variables in patients who were admitted to tertiary hospitals across Europe. Design: The 3 screening tools were applied in 2567 inpatients at 14 hospitals across 12 European countries. The classification of patients into different nutritional risk groups was compared between tools and related to anthropometric measures and clinical variables [e.g., length of hospital stay (LOS) and infection rates]. Results: A similar rate of completion of the screening tools for each tool was achieved (PYMS: 86%; STAMP: 84%; and STRONG KIDS : 81%). Risk classification differed markedly by tool, with an overall agreement of 41% between tools. Children categorized as high risk (PYMS: 25%; STAMP: 23%; and STRONG KIDS : 10%) had a longer LOS than that of children at low risk (1.4, 1.4, and 1.8 d longer, respectively; P , 0.001). In high-risk patients identified with the PYMS, 22% of them had low (,22) body mass index (BMI) SDscores (SDSs), and 8% of them had low height-for-age SDSs. For the STAMP, the percentages were 19% and 14%, respectively, and for the STRONG KIDS , the percentages were 23% and 19%, respectively. Conclusions: The identification and classification of malnutrition risk varied across the pediatric tools used. A considerable portion of children with subnormal anthropometric measures were not identified with all of the tools. The data obtained do not allow recommending the use of any of these screening tools for clinical practice. This study was registered at clinicaltrials.gov as NCT01132742. Am J Clin Nutr 2016;103:1301-10.

Although nutrition screening and assessment are recommended by European Society for Parenteral and Enteral Nutrition and the European Society for Pediatric Gastroenterology Hepatology and Nutrition and are often accepted to be required by healthcare facilities, there is no standardized approach to nutritional screening for pediatric inpatients. The near future will provide us with comparative data on the existing tools which may contribute to delineating a standard for useful nutrition screening in pediatrics.

AimsWe undertook a mixed‐methods evaluation of a Web‐based conferencing service (virtual consult) between general practitioners (GPs) and cardiologists in managing patients with heart failure in the community to determine its effect on use of specialist heart failure services and acceptability to GPs.Methods and resultsAll cases from June 2015 to October 2016 were recorded using a standardized recording template, which recorded patient demographics, medical history, medications, and outcome of the virtual consult for each case. Quantitative surveys and qualitative interviewing of 17 participating GPs were also undertaken. During this time, 142 cases were discussed—68 relating to a new diagnosis of heart failure, 53 relating to emerging deterioration in a known heart failure patient, and 21 relating to therapeutic issues. Only 17% required review in outpatient department following the virtual consultation. GPs reported increased confidence in heart failure management, a broadening of their knowledge base, and a perception of overall better patient outcomes.ConclusionsThese data from an initial experience with Heart Failure Virtual Consultation present a very positive impact of this strategy on the provision of heart failure care in the community and acceptability to users. Further research on the implementation and expansion of this strategy is warranted.

Sustainablity and transferability: Resourcing of this method of integrated care is required to ensure that both specialist and GP teams can participate fully without compromising other patient care. The use of webconferencing is easily transferable to settings internationally. Conclusions: These data from an initial experience with VC present a very positive impact of this strategy on the provision of heart failure care in the community and acceptability to users. In addition, it is likely that this strategy will have benefits in the management of other chronic illnesses, and therefore increased focus on and resourcing of such efforts may have a significant impact on the development of chronic disease strategies in the future. Further research on this strategy focusing on patient outcomes and acceptability, implementation science approaches and economic evaluations are required.