Outcome of nutritional screening in the acute paediatric setting

Abstract

These results suggest that nutritional screening tools have poor sensitivity and are difficult to interpret in the acute setting. It may be more effective to include the assessment of weight and height and nutritional intake in the context of the acute presentation as part of routine clinical assessment rather than relying on screening tools to identify those at risk.

Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in the Electronic Health Record: A Validation Study

“…The EHR-STAMP showed higher sensitivity (0.89) and specificity (0.97) than the original STAMP (0.63-0.81 and 0.36-0.91, respectively), with positive and negative predictive values comparable with those of the original STAMP validation study (PPV, 0.60 vs 0.55; NPV, 0.94 vs 0.95, respectively). 13,17,20 Using the validity algorithm published in the Academy's recent systematic review of pediatric nutrition screening tools, the EHR-STAMP tool has a moderate degree of overall validity, comparable with that of STAMP, as well as PYMS and STRONG(kids). 16 A strength of the current tool is that it is based on the well-designed, previously validated STAMP but modified to be relevant in the era of widespread EHR adoption.…”

Revisión sistemática y análisis comparativo de las herramientas de tamizaje nutricional en pediatría validadas en Europa y Canadá

“…Table 2 compiles and integrates the information from the 15 studies included in the literature review according to the PICO characteristics of the research. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] It should be noted that, although the search included original studies published between 2002 and 2017, the selected articles were released between 2010 and 2017 (67% of them were published between 2012 and 2017), thus indicating that the results are up-to-date. All studies were developed in European countries.…”

“…However, if good specificity (ability to detect true negatives) is also considered as a desirable characteristic, only the PYMS tool meets these two characteristics of concurrent validity. 35,39 It should be noted that these results are not consistent across studies, 26 partly because sensitivity and specificity tend to be inversely related. 45 In this regard, the meta-analysis by Huysentruyt et al, 46 by including gold standards to validate the tools, shows that there is a marked variation among the studies included.…”

“…27,32,34,36,39 Among the 10 studies for which the level of certainty was calculated, the Chourdakis et al 38 study had the highest level of certainty, mainly because it was carried out in 12 countries throughout Europe with a sample of 2 567 patients and because the results were consistent. In contrast, the level of certainty of the study by Thomas et al, 26 which was carried out in the United Kingdom, was considered low, particularly because it was a unicenter research with convenience sampling and inconsistent results. The remaining 8 studies were classified at a moderate level since they were multicenter studies, with randomized, systematized or consecutive sampling and generally consistent results that allow, to some extent, the generalization of findings to clinical practice.…”

Compliance with nutrition screening in a children’s hospital

“…We and others6 7 have previously demonstrated poor sensitivity and specificity with respect to the use of published nutritional screening tools to accurately identify those with increased nutritional risk, leading us to consider alternatives ways in which to better identify those children requiring additional nutrition support 6. Of interest, sections 1 and 2 of the NRST, relating to diagnosis and nutritional intake, were well completed.…”