title: Self-Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST).
abstract: Malnutrition is common in patients with inflammatory bowel disease (IBD) and is associated with poor outcomes. Our aim is to determine if patient self-administered malnutrition screening using the malnutrition universal screening tool (MUST) is reliable by comparing patient scores with those derived from the healthcare practitioner (HCP), the gold standard.
  
  
  
  We conducted a prospective validation study at a tertiary Canadian academic center that included 154 adult outpatients with IBD. All patients with IBD completed a self-administered nutrition screening assessment using the MUST score followed by an independent MUST assessment performed by HCPs. The main outcome measure was chance-corrected agreement (κ) of malnutrition risk categorization.
  
  
  
  For patient-administered MUST, the chance-corrected agreement κ (95% confidence interval [CI]) was 0.83 (0.74-0.92) when comparing low-risk and combined medium- and high-risk patients with HCP screening. Weighted κ analysis comparing all 3 risks groups yielded a κ (95% CI) of 0.85 (0.77-0.93) between patient and HCP screening. All patients were able to screen themselves. Overall, 96% of patients reported the MUST questionnaire as either very easy or easy to understand and to complete.
  
  
  
  Self-administered nutrition screening in outpatients with IBD is valid using the MUST screening tool and is easy to use. If adopted, this tool will increase utilization of malnutrition screening in hectic outpatient clinic settings and will help HCPs determine which patients require additional nutrition support.
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Amindeep
authors: A
authors: Sandhu
authors: Department of Medicine, Western University, London, Ontario, Canada Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada.
authors: Mahmoud
authors: M
authors: Mosli
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Brian
authors: B
authors: Yan
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Thomas
authors: T
authors: Wu
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Jamie
authors: J
authors: Gregor
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Nilesh
authors: N
authors: Chande
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Terry
authors: T
authors: Ponich
authors: Department of Medicine, Western University, London, Ontario, Canada.
authors: Melanie
authors: M
authors: Beaton
authors: Department of Medicine, Western University, London, Ontario, Canada Program of Experimental Medicine (POEM), Western University, London, Ontario, Canada Program of Experimental Medicine, Department of Medicine, Western University, London, Ontario, Canada. adam.rahman@sjhc.london.on.ca.
authors: Adam
authors: A
authors: Rahman
mesh_terms: D000328:Adult; D002170:Canada; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report
keywords: inflammatory bowel disease; malnutrition; nutrition assessment