title: Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) among hospital inpatients.
abstract: OBJECTIVE
  The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1).
  
  
  RESULTS
  According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.
  
  
  CONCLUSIONS
  The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.
authors.affiliation: Department of Clinical Nursing Sciences, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
authors.forename: Albert
authors.initials: A
authors.lastname: Westergren
authors.forename: Erika
authors.initials: E
authors.lastname: Norberg
authors.forename: Christina
authors.initials: C
authors.lastname: Vallén
authors.forename: Peter
authors.initials: P
authors.lastname: Hagell