scholarly journals Position of the Academy of Nutrition and Dietetics: Malnutrition (Undernutrition) Screening Tools for All Adults

2021 ◽  
pp. 1-3
Author(s):  
Annalynn Skipper ◽  
Anne Coltman ◽  
Jennifer Tomesko ◽  
Pamela Charney ◽  
Judith Porcari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical History ◽  
Screening Tool ◽  
The Body ◽  
Screening Tools ◽  
Current Evidence ◽  
Nutrition Screening ◽  
Simple Process ◽  
Nutrition And Dietetics ◽  
Robust Evidence

It is the position of the Academy of Nutrition and Dietetics that, based upon current evidence, the Malnutrition Screening Tool should be used to screen adults for malnutrition (undernutrition) regardless of their age, medical history, or setting. Malnutrition (undernutrition) screening is a simple process intended to quickly recognize individuals who may have a malnutrition diagnosis. While numerous malnutrition screening tools are in use, their levels of validity, agreement, reliability, and generalizability vary. The Academy of Nutrition and Dietetics reviewed the body of evidence supporting malnutrition screening tools and determined a single tool for identifying adults in all settings who may have malnutrition, regardless of their age or medical history. The Nutrition Screening for Adults Workgroup conducted a systematic review of the most robust evidence to promote using the highest-quality malnutrition screening tool available.

scholarly journals Psoriatic arthritis screening: a systematic review and meta-analysis

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 692-707 ◽  
Author(s):  
Nicolas Iragorri ◽  
Glen Hazlewood ◽  
Braden Manns ◽  
Vishva Danthurebandara ◽  
Eldon Spackman
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Screening Tools ◽  
Screening Questionnaire ◽  
Psa Screening ◽  
Early Psoriatic Arthritis

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.

Neurodevelopmental Treatment (Bobath) for Children With Cerebral Palsy: A Systematic Review

2019 ◽  
Vol 34 (11) ◽  
pp. 679-686 ◽  
Author(s):  
Márcia Andréa Zanon ◽  
Rafael Leite Pacheco ◽  
Carolina de Oliveira Cruz Latorraca ◽  
Ana Luiza Cabrera Martimbianco ◽  
Daniela Vianna Pachito ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cerebral Palsy ◽  
Physical Therapy ◽  
Randomized Clinical Trials ◽  
Risk Of Bias ◽  
The Body ◽  
Current Evidence ◽  
Children With Cerebral Palsy ◽  
Protocol Registration

Aim: To assess the effects of neurodevelopmental treatment for children with cerebral palsy. Methods: We conducted a systematic review following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance to PRISMA Statement. Through a comprehensive literature search we considered all randomized clinical trials that compared neurodevelopmental treatment with conventional physical therapy for children with cerebral palsy. We used the Cochrane Risk of Bias Table to assess the risk of bias of the included randomized clinical trial, and the GRADE approach to evaluate the certainty of the body of the evidence. Results: We found 3 randomized clinical trials (2 published and 1 ongoing) comprising 66 children. Published randomized clinical trials presented methodological and reporting limitations and only 1 provided data for outcomes of interest. No difference between neurodevelopmental treatment and conventional physical therapy was found for gross motor function (mean difference 1.40; 95% confidence interval –5.47 to 8.27, low certainty evidence). Conclusion: This review found that the effects of neurodevelopmental treatment for children with cerebral palsy are still uncertain. Further studies are required to assess the efficacy and safety of neurodevelopmental treatment for this purpose and until there, current evidence do not support its routinely use in practice. Number of protocol registration in PROSPERO database: CRD42017082817 (available from https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82817 ).

scholarly journals Neutrophil to Lymphocyte Ratio in Preeclampsia

2021 ◽  
pp. 115-118
Author(s):  
Alfian Prasetyo ◽  
Sheella Rima Bororing ◽  
Yuma Sukadarma
Keyword(s):  
Systematic Review ◽  
Diagnostic Criteria ◽  
Screening Tool ◽  
Neutrophil To Lymphocyte Ratio ◽  
Screening Tools ◽  
P Value ◽  
Lymphocyte Ratio

Abstract Objective: To determine the correlation between neutrophil to lymphocyte ratio and preeclampsia. To determine whether neutrophil to lymphocyte ratio can be used as a screening tool for preeclampsia.Methods: This study was conducted with a systematic review method. Articles that had been gathered and filtered were reviewed by QUADAS-2 tool. Guidelines from the American Congress of Obstetricians and Gynecologists (ACOG) and Pedoman Nasional Pelayanan Kedokteran were used as a diagnostic criteria for determining preeclampsiaResults: Studies conducted by Kirbas et al, Cakmak et al, Wang et al and Panwar et al stated that there is a correlation between neutrophil to lymphocyte ratio to preeclampsia (p-value < 0.05). Cut-off values are diverse between 3.5 - 5.6 with different sensitivity and specificity.Conclusion: This systematic review shows that there is a relationship between neutrophil to lymphocyte ratio and preeclampsia. Neutrophil to lymphocyte ratio can be used as screening tools for preeclampsia in the first trimester.Keywords: neutrophil to lymphocyte ratio, NLR, preeclampsia. Abstrak Tujuan: Mengetahui apakah terdapat hubungan antara rasio neutrofil terhadap limfosit dengan preeklampsia. Mengetahui apakah rasio neutrofil terhadap limfosit dapat dijadikan sebagai alat bantu skrining preeklampsia.Metode: Penelitian ini dilakukan dengan metode systematic review. Artikel yang disaring akan ditentukan kualitasnya menggunakan QUADAS-2. Kriteria diagnostik preeklampsia yang digunakan adalah American College of Obstetricians and Gynecologists (ACOG) untuk penelitian luar negeri dan Pedoman Nasional Pelayanan Kedokteran untuk penelitian dalam negeri.Hasil : Penelitian yang dilakukan oleh Kirbas et al, Cakmak et al, Wang et al, dan Panwar et al menyatakan bahwa terdapat hubungan antara rasio neutrofil terhadap limfosit dengan preeklampsia ( p-value < 0.05). Nilai cutoff dari rasio neutrofil terhadap preeklampsia beragam mulai dari 3.5 - 5.6 dengan sensitivitas dan spesifisitas yang berbeda-beda.Kesimpulan : Penelitian systematic review ini menunjukan bahwa rasio neutrofil terhadap limfosit memiliki hubungan dengan penyakit preeklampsia. Rasio neutrofil terhadap limfosit dapat dijadikan sebagai alat bantu skrining untuk preeklampsia pada trimester pertama.Kata kunci: rasio neutrofil terhadap Limfosit, NLR, preeklamsia.

scholarly journals Effectiveness of powered exoskeleton use on gait in individuals with cerebral palsy: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252193
Author(s):  
Lucinda Rose Bunge ◽  
Ashleigh Jade Davidson ◽  
Benita Roslyn Helmore ◽  
Aleksandra Daniella Mavrandonis ◽  
Thomas David Page ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Case Series ◽  
Gait Training ◽  
Evidence Base ◽  
The Body ◽  
Current Evidence ◽  
Childhood Disability ◽  
Ongoing Research ◽  
Current Evidence Base

Background Cerebral palsy (CP) is a leading cause of childhood disability. The motor impairments of individuals with CP significantly affect the kinematics of an efficient gait pattern. Robotic therapies have become increasingly popular as an intervention to address this. Powered lower limb exoskeletons (PoLLE) are a novel form of robotic therapy that allow the individual to perform over-ground gait training and yet its effectiveness for CP is unknown. Purpose To determine the effectiveness of PoLLE use on gait in individuals with CP. Method A systematic search of eight electronic databases was conducted in March 2020. Studies included children (0–18 years) and or adults (18+ years) diagnosed with CP who used a PoLLE for gait training. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement, with the methodology registered with PROSPERO (CRD42020177160). A modified version of the McMaster critical review form for quantitative studies was used to assess the methodological quality. Due to the heterogeneity of the included studies, a descriptive synthesis using the National Health & Medical Research Council (NHMRC) FORM framework was undertaken. Results Of the 2089 studies screened, ten case series and three case studies met the inclusion criteria highlighting the current evidence base is emerging and low level. A range of PoLLEs were investigated with effectiveness measured by using a number of outcome measures. Collectively, the body of evidence indicates there is some consistent positive evidence on the effectiveness of PoLLE in improving gait in individuals with CP, with minimal adverse effects. While this is a positive and encouraging finding for an emerging technology, methodological concerns also need to be acknowledged. Conclusion With rapidly evolving technology, PoLLEs could play a transformative role in the lives of people impacted by CP. Ongoing research is required to further strengthen the evidence base and address current methodological concerns.

Utilizing technology for malnutrition screening and referrals to nutrition services.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 284-284
Author(s):  
Susan Franco ◽  
Corrine Hanson ◽  
Glenda Woscyna ◽  
Jana Wells ◽  
Meghan McLarney
Keyword(s):  
Nursing Staff ◽  
Screening Tool ◽  
Screening Tools ◽  
Cancer Center ◽  
Oncology Patients ◽  
Record System ◽  
Nutrition Screening ◽  
Nutrition Risk ◽  
Positive Screen ◽  
Nutrition Services

284 Background: The incidence of disease-related malnutrition in oncology patients ranges from 40-80%. This is the highest of all hospital patient groups. Malnutrition is associated with decreased quality of life, increased healthcare costs and intolerance to treatment. Screening for nutrition risk is often lacking in outpatient settings. Electronic health records could be utilized to improve the delivery of validated nutrition screening tools such as the Malnutrition Screening Tool (MST) in outpatient oncology settings. Methods: We designed a pilot project (Feb-July 2018) to administer the MST for outpatient oncology patients seen at the Fred and Pamela Buffett Cancer Center (FPBCC) using an electronic medical record system. “Best Practice Alerts” (BPAs) were used to notify the nursing staff of a patient with a screen that was positive for nutrition risk (MST score ≥3). The BPA recommended a referral to nutrition services; nursing staff could choose to “order” or “do not order" a Nutrition Consult. Results: A total of 2,672 patients received MST screening during the pilot. Out of these, 223 (8%) had a positive screen for nutrition risk; 197 of these were eligible for a nutrition services referral. A BPA “fired” 152 times out of 197 eligible patients (77%). Of the197 eligible patients, 58 (29%) were actually referred to nutrition services. Of these 58 referrals, 43 (74%) were triggered based on a BPA, while the remaining referrals were received outside of a BPA. BPAs failed to fire 45/197 times (23%). Conclusions: An EHR-based nutrition screening system to increase referrals in patients identified at nutrition risk in an outpatient oncology setting was effective for 29% of eligible patients. Barriers encountered included failures in technology as well as human factors. During the pilot it was discovered that the BPA was firing in a location in the chart where the nurse did not regularly work. There was not a consistent message as to the goals and outcomes during the pilot which resulted in lack of awareness by nurses to respond to the nutrition risk score. Utilizing an EHR-based nutrition screening tool is an effective way to identify patients at risk and refer them to appropriate resources in a timely and efficient way.

scholarly journals Accuracy of Depression Screening Tools to Detect Major Depression in Children and Adolescents: A Systematic Review

2016 ◽  
Vol 61 (12) ◽  
pp. 746-757 ◽  
Author(s):  
Michelle Roseman ◽  
Lorie A. Kloda ◽  
Nazanin Saadat ◽  
Kira E. Riehm ◽  
Abel Ickowicz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Bound ◽  
Children And Adolescents ◽  
Screening Tool ◽  
Diagnostic Interview ◽  
Small Sample ◽  
Screening Tools ◽  
Depression Screening ◽  
Screening Programs ◽  
Small Sample Sizes

Objective: Depression screening among children and adolescents is controversial, and no clinical trials have evaluated benefits and harms of screening programs. A requirement for effective screening is a screening tool with demonstrated high accuracy. The objective of this systematic review was to evaluate the accuracy of depression screening instruments to detect major depressive disorder (MDD) in children and adolescents. Method: Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, HaPI, and LILACS databases from 2006 to September 30, 2015. Eligible studies compared a depression screening tool to a validated diagnostic interview for MDD and reported accuracy data for children and adolescents aged 6 to 18 years. Risk of bias was assessed with QUADAS-2. Results: We identified 17 studies with data on 20 depression screening tools. Few studies examined the accuracy of the same screening tools. Cut-off scores identified as optimal were inconsistent across studies. Width of 95% confidence intervals (CIs) for sensitivity ranged from 9% to 55% (median 32%), and only 1 study had a lower bound 95% CI ≥80%. For specificity, 95% CI width ranged from 2% to 27% (median 9%), and 3 studies had a lower bound ≥90%. Methodological limitations included small sample sizes, exploratory data analyses to identify optimal cut-offs, and the failure to exclude children and adolescents already diagnosed or treated for depression. Conclusions: There is insufficient evidence that any depression screening tool and cut-off accurately screens for MDD in children and adolescents. Screening could lead to overdiagnosis and the consumption of scarce health care resources.

scholarly journals A Systematic Review of Validated Screening Tools for Anxiety Disorders and PTSD in Low to Middle Income Countries

2020 ◽  
Author(s):  
Anisa Mughal ◽  
Jackson Devadas ◽  
Eric Ardman ◽  
Brooke Levis ◽  
Vivian F Go ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Screening Tool ◽  
Meta Analysis ◽  
Screening Tools ◽  
Clinical Population ◽  
Post Traumatic Stress ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Years

Abstract Background: Anxiety and post-traumatic stress disorder (PTSD) contribute significantly to disability adjusted life years in low- to middle-income countries (LMICs). Screening has been proposed to improve identification and management of these disorders, but little is known about the validity of screening tools for these disorders. We conducted a systematic review of validated screening tools for detecting anxiety and PTSD in LMICs. Methods: MEDLINE, EMBASE, Global Health and PsychINFO were searched (inception-January 10, 2019). Eligible studies (1) screened for anxiety disorders and/or PTSD; (2) reported sensitivity and specificity for a given cut-off value; (3) were conducted in LMICs; and (4) compared screening results to diagnostic classifications based on a reference standard. Screening tool, cut-off, disorder, region, country, and clinical population were extracted for each included study. We assed quality using a modified version of Greenhalgh’s ten item checklist. Accuracy results were organized based on screening tool, cut-off, and specific disorder. Accuracy estimates for the same cut-off for the same screening tool and disorder were combined via meta-analysis.ResultsOf 5343 unique citations identified, 57 articles including 75 screening tools were included. There were 44, 20 and 11 validations for anxiety, PTSD, and combined depression and anxiety, respectively. Continentally, Asia had the most validations (34). Regionally, South Asia (10) had the most validations, followed by West Asia (9) and South Africa (9). The Kessler-10 (7) and the Generalized Anxiety Disorder-7 item scale (GAD-7) (6) were the most commonly validated tools for anxiety disorders, while the Harvard Trauma Questionnaire (3) and Posttraumatic Diagnostic Scale (3) were the most commonly validated tools for PTSD. Most studies (27) had the lowest quality rating (unblinded) followed by good (21). Due to incomplete reporting, we combined only two sets of accuracy values in meta-analysis (GAD-7 cut-off ≥10; sensitivity: 76%, specificity: 64%).ConclusionUse of brief screening instruments can bring much needed attention and research opportunities to various at-risk LMIC populations, yet many have been validated in inadequately designed studies. Locally validated screening tools for anxiety and PTSD need further evaluation and well-designed studies, including clinical trials, to determine whether their use can reduce the burden of disease. PROSPERO registry number: CRD42019121794

scholarly journals Scoping Review of Dance for Adults With Fibromyalgia: What Do We Know About It? (Preprint)

2018 ◽  
Author(s):  
Julia Bidonde ◽  
Catherine Boden ◽  
Soo Kim ◽  
Angela J Busch ◽  
Suelen M Goes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Symptom Management ◽  
Physical Activity Intervention ◽  
Grey Literature ◽  
Well Being ◽  
The Body ◽  
Current Evidence ◽  
Research Activity ◽  
Dance Movement

BACKGROUND Fibromyalgia is a chronic disorder characterized by widespread muscular tenderness, pain, fatigue, and cognitive difficulties. Nonpharmacological treatment options, such as physical activity, are important for people with fibromyalgia. There are strong recommendations to support engagement in physical activity for symptom management among adults with fibromyalgia. Dance is a mode of physical activity that may allow individuals with fibromyalgia to improve their physical function, health, and well-being. Dance has the potential to promote improved pain processing while simultaneously providing the health and social benefits of engaging in physical activity that contributes to symptom management and overall function rehabilitation. However, we are unaware of current evidence on dance as a nonpharmacological/physical activity intervention for adults with fibromyalgia. OBJECTIVE The aims of this study were to understand how dance is used therapeutically by individuals with fibromyalgia; to examine the extent, range and nature of research activity in the area; and to determine the value of undertaking a systematic review of interventions. METHODS We used and adapted the Arksey and O’Malley scoping framework. The search strategy involved a comprehensive search of main health and electronic social databases, trial registries and grey literature without language limits. Pairs of reviewers independently screened and extracted data and evaluated the methodological quality of randomized control trials. RESULTS Twenty-one unique records for 13 studies met inclusion criteria; the studies included mostly middle-aged women. Types of dance included were aerobic dance, belly dance, dance movement therapy, biodanza and Zumba. Intervention parameters were different among studies. Frequency varied between one to three times a week; all were done in small group settings. Studies evaluated a variety of outcomes in the symptoms, wellness, psychosocial, physical functioning, balance and fitness categories; no studies evaluated the safety or adverse events systematically which is a major weakness of the literature. CONCLUSIONS There are few studies in the field of dance and fibromyalgia, suggesting research is in its infancy but slowly growing. They are of European and South American origin, focusing on female participants and a limited number of dance modes. Because the body of literature is small, of low quality and highly heterogeneous, we concluded that a systematic review of interventions on dance is not warranted at this time.

scholarly journals Omitting the First Step of GLIM Framework Yielded Better Accordance With PG-SGA in Chinese Ambulatory Cancer Patients: a Prospective Cross-sectional Study

2021 ◽  
Author(s):  
Yanfei Wang ◽  
Ziqi Liu ◽  
yunyi Wang ◽  
Xiaoyan Chen ◽  
Zhongfen Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Severe Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Predictive Values

Abstract Background and Aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a new framework for diagnosing malnutrition in combination of phenotypic and etiologic criteria after nutrition screening using validated screening tools. The aim of this study was to evaluate the efficacy of malnutrition screening tool (MST), malnutrition universal screening tool (MUST) and nutritional risk screening 2002 (NRS2002) as the first step of GLIM framework in comparison to Patients-Generated Subjective Global Assessment (PG-SGA) in Chinese ambulatory cancer patients.Methods: A single-center prospective cross-sectional study was conducted. Nutritional screening and assessment were performed within 4h after admission to the hospital using a structured questionnaire including MST, MUST, NRS2002, PG-SGA and GLIM, with supplement information of calf circumference (CC) measurement and body composition measurement using bioelectrical impedance analysis (BIA). Malnutrition diagnosis made by GLIM framework using MST, MUST or NRS2002 as the first step or without screening step were compared to PG-SGA separately. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and κ values were used to evaluate performance of the screening tools.Results: Of the 562 included patients, Of the participants 62.8% (355/562) were male and 37.2% (210/562) were female, with a male to female radio of 1.69:1. The median age of the patients was 59.0 years (range, 21-82y; interquels range 52.0-65.0y). From the 562 patients included in the study, 41.8% of patients were evaluated as malnutrition (PG-SGA≥4) and 11.9% were diagnosed as severe malnutrition (PG-SGA D). For GLIM criteria, omitting the screening step yielded fair accordance with PG-SGA in diagnosing malnutrition (κ=0.623) and severe malnutrition (κ=0.515). Using MUST as the first step of GLIM framework has better performance (κ=0.614; κ=0.515) than using MST (κ=0.504, κ=0.496) or NRS2002 (κ=0.363, κ=0.503) as the screening tool regardless of severity gradings.Conclusions: Using PG-SGA as the standard, GLIM framework omitting first step has better performance compared with using MST, MUST or NRS2002 as the screening tool. Among the screening tools validated to be used in the first step of GLIM framework, MUST may be the better choice for ambulatory cancer patients.

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