Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition

Background and aims: Malnutrition is related to increased mortality and poor outcome. Therefore, early diagnosis and intervention of malnutrition are recommended. However, the optimal nutrition screening tool for diagnosing malnutrition remains undetermined. This study aimed to verify the discrimina...

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Main Authors: Kotono Oishi, MSc, Arisa Inoue-Hamano, PhD, Yasuhiro Hamada, MD,PhD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:American Journal of Medicine Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667036424000232
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author Kotono Oishi, MSc
Arisa Inoue-Hamano, PhD
Yasuhiro Hamada, MD,PhD
author_facet Kotono Oishi, MSc
Arisa Inoue-Hamano, PhD
Yasuhiro Hamada, MD,PhD
author_sort Kotono Oishi, MSc
collection DOAJ
description Background and aims: Malnutrition is related to increased mortality and poor outcome. Therefore, early diagnosis and intervention of malnutrition are recommended. However, the optimal nutrition screening tool for diagnosing malnutrition remains undetermined. This study aimed to verify the discrimination and difficulty of nutrition screening items through item response theory (IRT) analysis and develop a simpler malnutrition screening tool. Methods: This study enrolled 10,375 patients aged ≥18 years who were admitted at Tokushima University Hospital. Patients who were pregnant had short-term hospitalization (≤3 days), were hospitalized only in the weekend, could not hear clearly, and were hospitalized merely for examination were excluded. A skilled dietitian performed the Subjective Global Assessment, rating a good nutritional status as A, moderate malnutrition as B, and severe malnutrition as C. Results: According to Subjective Global Assessment, we classified 7119 patients as A, 2892 as B, and 364 as C. Between these classes, the total number of application items was significantly lower in class A but significantly higher in class C. In the discrimination of each item calculated by IRT analysis, the highest discrimination item was “Has your food intake been less than usual?”, followed by “Have you had anorexia?”, “Have you had vomiting?”, “Have you had nausea?”, “Have you had dehydration?”, and “Have you lost weight?”. Conclusions: Human Key Tool of Nutrition, which is based on the IRT analysis results, is a new simple nutrition screening tool developed by us. Human Key Tool of Nutrition can contribute to the widespread use of nutrition screening.
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spelling doaj-art-958c6424cd4948f589094921ae9bd0d42025-01-31T05:12:37ZengElsevierAmerican Journal of Medicine Open2667-03642025-06-0113100086Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of NutritionKotono Oishi, MSc0Arisa Inoue-Hamano, PhD1Yasuhiro Hamada, MD,PhD2Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanRequests for reprints should be addressed to Yasuhiro Hamada, Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan.; Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanBackground and aims: Malnutrition is related to increased mortality and poor outcome. Therefore, early diagnosis and intervention of malnutrition are recommended. However, the optimal nutrition screening tool for diagnosing malnutrition remains undetermined. This study aimed to verify the discrimination and difficulty of nutrition screening items through item response theory (IRT) analysis and develop a simpler malnutrition screening tool. Methods: This study enrolled 10,375 patients aged ≥18 years who were admitted at Tokushima University Hospital. Patients who were pregnant had short-term hospitalization (≤3 days), were hospitalized only in the weekend, could not hear clearly, and were hospitalized merely for examination were excluded. A skilled dietitian performed the Subjective Global Assessment, rating a good nutritional status as A, moderate malnutrition as B, and severe malnutrition as C. Results: According to Subjective Global Assessment, we classified 7119 patients as A, 2892 as B, and 364 as C. Between these classes, the total number of application items was significantly lower in class A but significantly higher in class C. In the discrimination of each item calculated by IRT analysis, the highest discrimination item was “Has your food intake been less than usual?”, followed by “Have you had anorexia?”, “Have you had vomiting?”, “Have you had nausea?”, “Have you had dehydration?”, and “Have you lost weight?”. Conclusions: Human Key Tool of Nutrition, which is based on the IRT analysis results, is a new simple nutrition screening tool developed by us. Human Key Tool of Nutrition can contribute to the widespread use of nutrition screening.http://www.sciencedirect.com/science/article/pii/S2667036424000232Item response theoryNutrition screeningSubjective Global Assessment
spellingShingle Kotono Oishi, MSc
Arisa Inoue-Hamano, PhD
Yasuhiro Hamada, MD,PhD
Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
American Journal of Medicine Open
Item response theory
Nutrition screening
Subjective Global Assessment
title Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
title_full Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
title_fullStr Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
title_full_unstemmed Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
title_short Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition
title_sort development of a new malnutrition screening tool for patients human key tool of nutrition
topic Item response theory
Nutrition screening
Subjective Global Assessment
url http://www.sciencedirect.com/science/article/pii/S2667036424000232
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