Cut-off scores for the Minimal Eating Observation and Nutrition Form–Version II (MEONF-II) among hospital inpatients

Abstract

Background and objectiveThe newly developed Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.DesignCross-sectional study.MethodsThe study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity–1).ResultsAccording to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.ConclusionsThe suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

Improving nursing students research knowledge through participation in a study about nutrition, its associated factors and assessment

“…the study can be viewed as a naturalistic study. Furthermore, the rates of moderate/high risk of undernutrition in this study is very similar to that reported in other studies using a restricted number of registered nurses for data collection [3,4] with good inter-rater reliability (kappa, 0.81) [25] in this type of patient populations. Also other aspects of our observations support accuracy of data as they replicate previous findings (see below).…”

“…This was done following each patient assessment. These questions have previously been used to assess the user-friendliness of the MEONF-II [3][4][5] .…”

“…MEONF-II yields a total score ranging from 0-8. A score of 0-2 is interpreted as low risk for undernutrition, a score of 3-4 is considered a moderate risk, and a score ≥5 as high risk for undernutrition [4] . MEONF-II has shown a sensitivity of 0.61-0.73, specificity 0.79-0.88, and accuracy of 0.68-0.82 when compared with the MNA [3,5] .…”

“…It was developed to be used by nurses. Studies have shown promising sensitivity and accuracy compared to other screening instruments [3][4][5] , and its user-friendliness has been shown to be excellent among registered nurses [3,5] . However, it remains to be determined how it is experienced by undergraduate nursing students.…”

“…By involving nursing students in real research projects it is possible to integrate the three corner stones [2] , as was done in this study focusing on screening of nutritional risk using the Minimal Eating Observation Form (MEONF-II [3][4][5] ). Its relationship to other clinical problems has not been explored and its user friendliness when used by nursing students also remains to be addressed.…”