title: A systematic review of malnutrition screening tools for the nursing home setting.
abstract: BACKGROUND
  Malnutrition screening among nursing home residents is often performed with tools developed for use among older subjects, and sometimes with tools designed for an adult population. Only a few tools have been designed specifically for the nursing home setting. This systematic review assesses the criterion and predictive validity of malnutrition screening tools used in nursing homes.
  
  
  METHODS
  The databases MEDLINE, CINAHL, and EMBASE were searched on January 30, 2013, for manuscripts including search terms for malnutrition, screening or assessment tools, and setting. Articles were eligible for inclusion if they expressed criterion validity (how well can a tool assess nutritional status) or predictive validity (how well can a tool predict clinical outcome) of malnutrition screening tools in a nursing home population. Included were articles that had been published in the English, German, French, Dutch, Spanish, or Portuguese language.
  
  
  RESULTS
  The search yielded 8313 references. Of these, 24 met the inclusion criteria and were available; 2 extra manuscripts were retrieved by reference checking. Twenty tools were identified. Seventeen studies reported on criterion validity, and 9 on predictive validity. Four of the tools had been designed specifically for use in long term care. None of the tools, not even the ones specifically designed for the nursing home setting, performed (on average) better than "fair" in either assessing the residents' nutritional status or in predicting malnutrition-related outcomes.
  
  
  CONCLUSIONS
  The use of existing screening tools for the nursing home population carries limitations, as none performs better than "fair" in assessing nutritional status or in predicting outcome. Also, no superior tool can be pointed out. This systematic review implies that further considerations regarding malnutrition screening among nursing home residents are required.
authors.affiliation: Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition, Sports, and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands. Electronic address: m.vanbokhorst@vumc.nl.
authors.forename: Marian A E
authors.initials: MAE
authors.lastname: van Bokhorst-de van der Schueren
authors.affiliation: Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Patrícia Realino
authors.initials: PR
authors.lastname: Guaitoli
authors.affiliation: Medical Library, VU Amsterdam University Library, Amsterdam, The Netherlands.
authors.forename: Elise P
authors.initials: EP
authors.lastname: Jansma
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henrica C W
authors.initials: HCW
authors.lastname: de Vet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008403:Mass Screening / Q000295:instrumentation*; D009735:Nursing Homes
keywords: Malnutrition; assessment; criterion validity; long term care; nursing home; predictive validity; screening; systematic review