title: Self-reporting of height and weight: valid and reliable identification of malnutrition in preoperative patients.
abstract: BACKGROUND
  Preoperative screening for malnutrition has become mandatory in The Netherlands. A sensitive method to diagnose malnutrition would save time and improve effectiveness.
  
  
  METHODS
  A prospective cross-sectional study of 488 adult elective preoperative outpatients was performed. The accuracy of self-reported height and weight was compared with measured data and 3 commonly used malnutrition screening tools. Interobserver agreement was calculated by the intraclass correlation coefficient, studied in Bland and Altman plots, and analyzed by using Cohen's κ statistic. Accuracy was expressed in sensitivity, specificity, and false-negative rates.
  
  
  RESULTS
  Differences between self-reported and measured data were significant, but clinically irrelevant, because only 1 patient was falsely identified as well nourished. Intraclass correlation coefficient for height, weight, and body mass index was high (.97-.99). Bland-Altman plots showed that the mean ± standard deviation differences and 95% limits of agreement between both methods were as follows: height, .0096 m (±.0262, -.0417 to +.0609 m); weight, -1.28 kg (±2.29, -5.76 to +3.20 kg); body mass index, -.72 kg/m(2) (±1.11, -2.92 to +1.46 kg/m(2)). The κ coefficient was .84 (95% confidence interval, .75-.94). Sensitivity was .97 and specificity was .98. Sensitivity and false-negative rates of self-reported data were better overall compared with the screening tools.
  
  
  CONCLUSIONS
  Self-reported data provide highly sensitive information to diagnose malnutrition in preoperative outpatients.
authors.affiliation: Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, Noord-Holland, The Netherlands. e.b.haverkort@amc.uva.nl
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Haverkort
authors.forename: Rob J
authors.initials: RJ
authors.lastname: de Haan
authors.forename: Jan M
authors.initials: JM
authors.lastname: Binnekade
authors.forename: Marian A E
authors.initials: MA
authors.lastname: van Bokhorst-de van der Schueren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D001827:Body Height; D001835:Body Weight; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D009426:Netherlands; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D055815:Young Adult