Validation of a nutrition risk screening tool for children and adolescents with cystic fibrosis ages 2-20 years.
OBJECTIVE
According to the 2002 Cystic Fibrosis (CF) Foundation nutrition consensus report, children with CF should grow normally. Cross-sectional data from the foundation's patient registry concluded that a body mass index at or greater than the 50th percentile is associated with better lung function. A consistent, evidence-based screening process can identify those individuals with CF having nutrition risk factors associated with a decrease in pulmonary function, target early intervention, and prevent further decline. A tool for screening nutrition risk is described to identify those children with CF who would benefit from more extensive nutrition intervention.


METHODS
The proposed screening tool is a risk-based classification system with 3 categories: weight gain, height velocity, and body mass index. The CF Foundation recommendations regarding these parameters are incorporated, with risk points assigned when minimum body mass index, weight gain, and/or height gain standards are unmet.


RESULTS
An interrater measure of agreement determined a satisfactory level of reliability (kappa = 0.85). Patient records (n = 85) were reviewed to determine nutrition status category (no risk or at risk) of this tool compared with the CF Foundation 2002 Nutrition Consensus, yielding sensitivity and specificity at 84% and 75%, respectively. A second comparison was made with combined, independent nutrition risk factors not included in the screening tool. The sensitivity and specificity of the screening tool compared with the combined risk factors were 86% and 78%, respectively.


CONCLUSIONS
This tool for screening nutrition risk for CF is reliable and valid, with consistent, reproducible results, free from subject or observer bias.
McDonald
Catherine M
CM
Intermountain Cystic Fibrosis Center, Pediatric Division, University of Utah Medical Center, Primary Children's Medical Center, Salt Lake City, Utah 84113, USA. katie.mcdonald@imail.org
D000293:Adolescent; D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D015362:Child Nutrition Disorders / Q000175:diagnosis* / Q000209:etiology; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015430:Weight Gain