Comparison of Content and Psychometric Properties of Malnutrition Outcome Measures: A Systematic Review.
Līga Savicka, Santa Salaka, Guna Bērziņa
PMID 35445276WHAT IT FOUND
For malnutrition, BMI is the most commonly used measure but is not enough alone.
MNA is recommended for older patients, MUST for hospitalized patients, and PG-SGA covers the broadest range of issues.
Key findings
01The review identified 215 malnutrition outcome measures, and BMI was the most commonly used component.
02MNA measured what it intended in older adults, detected change in all populations tested except Iranian older adults, and the Portuguese version did not fit the intended concept in Brazilian older adults.
03PG-SGA mapped to 25 categories of body functions, structures, activities and environment, the most of the functional tools reviewed, but lacked clear evidence about whether scores detect meaningful change.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review did not assess the methodological quality of the included studies, so weak studies count as much as strong ones. It included lower-level evidence such as case reports, which can describe what happened but cannot establish how well a measure works. One reviewer screened titles and abstracts, so eligible studies could have been missed. The search was limited to English articles from 2010 to October 2019 in adults aged 18 years or older. Reviewer agreement was lower for comprehensive functional measures because their items were harder to interpret, and some concepts were left without a final ICF link. Several tools had missing or unclear information about whether they measured what they intended, compared with standards, had extreme score problems, or had interpretable scores. Some studies used methods that did not meet the review's criteria, so results were marked indeterminate rather than positive or poor. The review did not give an overall quality score, so there is no single objective answer about the best tool in all cases.
The easy way to misread this
Do not treat MNA or MUST as proven to improve patient outcomes. This review assessed malnutrition outcome measures and their measurement properties, not the effects of using them in treatment, and it gave no overall quality score for one best tool in all cases.