Reproducibility and Inter-rater Reliability of 2 Paediatric Nutritional Screening Tools.
The aim of the present study was to assess reproducibility and inter-rater reliability of 2 nutritional screening tools (NST): Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP).



Prospective observational multicentre study. Patients ages 1 month or older admitted to paediatric or surgical wards were tested within 24 hours of admission by 2 independent observers: experts specialized in paediatric nutrition (physicians or dieticians) and clinical staff nonexpert in nutrition. Diagnosis on admission, underlying diseases, and length of stay were registered.



Kappa index (κ) to evaluate agreement between observers.



A total of 223 patients were included (53.4% boys), with mean age of 5.59 (95% confidence interval 4.94-6.22) years. Experts classified 9.9% of patients at high risk with STRONGkids and 19.7% using STAMP, whereas nonexpert staff assigned 6.7% of patients to the high-risk category with STRONGkids and 21.9% with STAMP. Agreement between expert and nonexpert staff was good: 94.78% for STRONGkids (κ 0.72 [P < 0.001]); 92.55% for STAMP (κ 0.74 [P < 0.001]). The rate of malnutrition was significantly higher among high-risk patients with both NST, independent of examiner experience. After adjusting for age, both STRONGkids and STAMP high-risk scores predicted longer length of stay, whether assessed by experts or nonexperts, although differences were higher with STRONGkids.



Agreement between experts and nonexpert staff in nutrition was good, producing a similar high-risk patient profile. Our results demonstrate that these NSTs are appropriate for nutritional screening in settings in which users have no previous experience in the field.
*On behalf of GETNI (Grupo Español de Trabajo en Nutrición Infantil) †Complejo Hospitalario Torrecárdenas, Almería ‡Hospital Universitario La Paz, Madrid §Hospital Universitario Virgen Macarena, Sevilla ||IIS Aragón, Hospital Clínico Universitario Lozano Blesa Zaragoza ¶Hospital Infantil Universitario Miguel Servet, Zaragoza #Centro Médico D-Medical, Madrid, Spain.
Rafael
R
Galera-Martínez
Ana
A
Moráis-López
Maria Del C
MD
Rivero de la Rosa
Laura
L
Escartín-Madurga
Encarnación
E
López-Ruzafa
Ignacio
I
Ros-Arnal
Hector
H
Ruiz-Bartolomé
Gerardo
G
Rodríguez-Martínez
Rosa A
RA
Lama-More
D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment