Indications and limitations of the use of subjective global assessment in clinical practice: an update.
OBJECTIVE
Subjective global assessment is a clinical tool for assessing nutritional status that merges alterations in body composition and physiological function. Although it was first described almost two decades ago, many studies using this method have been published during the past few years. This review describes recent findings from such studies.


RESULTS
Subjective global assessment has proved to be a good nutritional assessment and prognostic indicator in several clinical situations. Agreement between subjective global assessment and newer screening methods is not always acceptable, and it has not been validated with respect to clinical outcome. Some modifications have been suggested that may increase the sensitivity of subjective global assessment as a screening tool. A scored version of subjective global assessment for cancer patients is now being validated for use in other patient groups. This could increase its utility in nutritional intervention studies if it can be demonstrated that subtle changes in nutritional status are reflected by numerical scores in patient-generated subjective global assessment.


CONCLUSIONS
Subjective global assessment represents a good option for assessing nutritional status in various clinical situations. As a screening tool, it better identifies established malnutrition than nutritional risk but its sensitivity is suboptimal. The scored version of subjective global assessment may have advantages and extend the usefulness of this tool even further.
Barbosa-Silva
M Cristina G
MC
Department of Surgery, Catholic University of Pelotas, RS, Brasil. cristinagbs@hotmail.com
Barros
Aluísio J D
AJ
D006801:Humans; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods*; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis*; D009752:Nutritional Status; D011379:Prognosis; D012680:Sensitivity and Specificity