title: Content validity across methods of malnutrition assessment in patients with cancer is limited.
abstract: To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition.
  
  
  
  Systematic review of studies in cancer patients that operationalized malnutrition as a variable, published since 1998. Eleven key concepts, within the three domains reflected by the malnutrition definitions acknowledged by European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN): A: nutrient balance; B: changes in body shape, body area and body composition; and C: function, were used to classify content validity of methods to assess malnutrition. Content validity indices (M-CVIA-C) were calculated per assessment method. Acceptable content validity was defined as M-CVIA-C ≥ 0.80.
  
  
  
  Thirty-seven assessment methods were identified in the 160 included articles. Mini Nutritional Assessment (M-CVIA-C = 0.72), Scored Patient-Generated Subjective Global Assessment (M-CVIA-C = 0.61), and Subjective Global Assessment (M-CVIA-C = 0.53) scored highest M-CVIA-C.
  
  
  
  A large number of malnutrition assessment methods are used in cancer research. Content validity of these methods varies widely. None of these assessment methods has acceptable content validity, when compared against a construct based on ESPEN and ASPEN definitions of malnutrition.
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714CE Groningen, The Netherlands. Electronic address: m.j.sealy@pl.hanze.nl.
authors.forename: Martine J
authors.initials: MJ
authors.lastname: Sealy
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714CE Groningen, The Netherlands.
authors.forename: Willemke
authors.initials: W
authors.lastname: Nijholt
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre-University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Department of Physiotherapy, Netherlands Cancer Institute, Postbus 90203, 1006 BE Amsterdam, The Netherlands.
authors.forename: Martijn M
authors.initials: MM
authors.lastname: Stuiver
authors.affiliation: Department of Dietetics, Bethesda Hospital, Dr. G.H. Amshoffweg 1, 7909 AA Hoogeveen, The Netherlands.
authors.forename: Marit M
authors.initials: MM
authors.lastname: van der Berg
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
authors.forename: Jan L N
authors.initials: JL
authors.lastname: Roodenburg
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714CE Groningen, The Netherlands; Department of Rehabilitation Medicine, University of Groningen, University Medical Center, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
authors.forename: Cees P
authors.initials: CP
authors.lastname: van der Schans
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714CE Groningen, The Netherlands; Ottery & Associates, LLC, 1145 Museum Blvd #411, Vernon Hills (Chicago), 60061, Illinois, USA.
authors.forename: Faith D
authors.initials: FD
authors.lastname: Ottery
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714CE Groningen, The Netherlands; Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
authors.forename: Harriët
authors.initials: H
authors.lastname: Jager-Wittenaar
mesh_terms: D035843:Biomedical Research / Q000379:methods / Q000592:standards; D003625:Data Collection / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000503:physiopathology*; D009369:Neoplasms / Q000503:physiopathology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015203:Reproducibility of Results
keywords: Cancer; Content validity; Malnutrition; Malnutrition assessment; Nutritional assessment; Undernutrition