Concurrent and predictive validity of nutritional screening tools in hospitalized pediatric patients: Protocol for a single-center, prospective, observational study

Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients

This study investigated the application of the transtheoretical (stages-of-change) model in audiologic rehabilitation. More specifically, it described the University of Rhode Island Change Assessment (URICA) scores of adults with acquired hearing impairment. It reported the psychometric properties (construct, concurrent, and predictive validity) of the stages-of-change model in this population. At baseline, 153 adults with acquired hearing impairment seeking help for the first time completed the URICA as well as measures of degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Participants were subsequently offered intervention options: hearing aids, communication programs, and no intervention. Their intervention uptake and adherence were assessed 6 months later and their intervention outcomes were assessed 3 months after intervention completion. First, the stages-of-change construct validity was evaluated by investigating the URICA factor structure (principal component analysis), internal consistency, and correlations between stage scores. The URICA scores were reported in terms of the scores for each stage of change, composite scores, stages with highest scores, and stage clusters (cluster analysis). Second, the concurrent validity was assessed by examining associations between stages of change and degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Third, the predictive validity was evaluated by investigating associations between stages of change and intervention uptake, adherence, and outcomes. First, in terms of construct validity, the principal component analysis identified four instead of three stages (precontemplation, contemplation, preparation, and action) for which the internal consistency was good. Most of the sample was in the action stage. Correlations between stage scores supported the model. Cluster analysis identified four stages-of-change clusters, which the authors named active change, initiation, disengagement, and ambivalence. In terms of concurrent validity, participants who reported a more advanced stage of change had a more severe hearing impairment, reported greater hearing disability, and had a hearing impairment for a longer period of time. In terms of predictive validity, participants who reported a more advanced stage of change were more likely to take up an intervention and to report successful intervention outcomes. However, stages of change did not predict intervention adherence. The majority of the sample was in the action stage. The construct, concurrent, and predictive validity of the stages-of-change model were good. The stages-of-change model has some validity in the rehabilitation of adults with hearing impairment. The data support that change might be better represented on a continuum rather than by movement from one step to the next. Of all the measures, the precontemplation stage score had the best concurrent and predictive validity. Therefore, further research should focus on addressing the precontemplation stage with a measure suitable for clinical use.

There are many nutrition screening tools currently being applied in hospitals to identify risk of malnutrition. However, multivariate statistical models are not usually employed to take into account the importance of each variable included in the instrument's development. To develop and evaluate the concurrent and predictive validities of a new screening tool of nutrition risk. A prospective cohort study was developed, in which 4 nutrition screening tools were applied to all patients. Length of stay in hospital and mortality were considered to test the predictive validity, and the concurrent validity was tested by comparing the Nuritional Risk in Emergency (NRE)-2017 to the other tools. A total of 748 patients were included. The final NRE-2017 score was composed of 6 questions (advanced age, metabolic stress of the disease, decreased appetite, changing of food consistency, unintentional weight loss, and muscle mass loss) with answers yes or no. The prevalence of nutrition risk was 50.7% and 38.8% considering the cutoff points 1.0 and 1.5, respectively. The NRE-2017 showed a satisfactory power to indentify risk of malnutrition (area under the curve >0.790 for all analyses). According to the NRE-2017, patients at risk of malnutrition have twice as high relative risk of a very long hospital stay. The hazard ratio for mortality was 2.78 (1.03-7.49) when the cutoff adopted by the NRE-2017 was 1.5 points. NRE-2017 is a new, easy-to-apply nutrition screening tool which uses 6 bi-categoric features to detect the risk of malnutrition, and it presented a good concurrent and predictive validity.

Malnutrition screening tool and malnutrition universal screening tool as a predictors of prolonged hospital stay and hospital mortality: A cohort study

A nursing minimum dataset for documenting nutritional care for adults in primary healthcare: a scoping review protocol

Nutrition screening tool selection can be difficult. This review critically examines the relevance of validity, specifically concurrent (agreement between tools) and predictive validity (prediction of outcomes), which have been the focus of several recent studies. An operational framework for screening tool selection is provided to contextualise the findings. Studies of predictive and concurrent validity involving screening tools comprising a variable number of nutritional and non-nutritional items (some nonmodifiable) have yielded inconsistent results. The use of one tool as a gold standard to judge the relative merits of other tools can be misleading because there is no agreed gold standard and different tools were designed for diagnostic, prognostic or other purposes. The use of observed outcomes (without nutritional intervention) as the gold standard may not adequately reflect the value of tools designed to assess nutritional status and need for nutritional intervention. Over-reliance on concurrent and predictive validity can be confusing and even counter-productive if used inappropriately. A proposed framework for screening tool selection indicates many factors should be considered so that there is purpose and harmony between the screening tool and the screening programme.

Nutrition Screening in Geriatric Rehabilitation: Criterion (Concurrent and Predictive) Validity of the Malnutrition Screening Tool and the Mini Nutritional Assessment−Short Form

Implementation of an Automated Pediatric Malnutrition Screen Using Anthropometric Measurements in the Electronic Health Record

BackgroundAs the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions.MethodsA sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders.ResultsConcurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration.DiscussionIn this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations.ConclusionAssessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.

Background: Recent clinical guidelines for adults with neurological disabilities suggest the need to assess measures of static and dynamic balance using the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) as core outcome measures. Given that the BBS measures both static and dynamic balance, it was unclear as to whether either of these instruments was superior in terms of its convergent and concurrent validity, and whether there was value in complementing the BBS with the DGI. Objective: The objective was to evaluate the concurrent and convergent validity of the BBS and DGI by comparing the performance of these two functional balance tests in people with multiple sclerosis (MS). Methods: Baseline cross-sectional data on 75 people with MS were collected for use in this study from 14 physical therapy clinics participating in a large pragmatic cluster-randomized trial. Convergent validity estimates between the DGI and BBS were examined by comparing the partial Spearman correlations of each test to objective lower extremity functional measures (Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), Timed 25-Foot Walk (T25FW) test) and the self-reported outcomes of physical functioning and general health using the 36-Item Short Form Health Survey (SF-36). Concurrent validity was assessed by applying logistic regression with gait disability as the binary outcome (Patient Determined Disease Steps (PDDS) as the criterion measure). The predictive ability of two models, a reduced/parsimonious model including the BBS only and a second model including both the BBS and DGI, were compared using the adjusted coefficient of determinations. Results: Both the DGI and BBS were strongly correlated with lower extremity measures overall as well as across the two PDSS strata with correlations. In PDDS ≤ 2, the difference in the convergence of BBS with TUG and DGI with TUG was −0.123 (95% CI: −0.280, −0.012). While this finding was statistically significant at a type 1 error rate of 0.05, it was not significant (Hommel’s adjusted p-value = 0.465) after accounting for multiple testing corrections to control for the family-wise error rate. The BBS–SF-36 physical functioning correlation was at least moderate and significant overall and across both PDDS strata. However, the DGI–physical functioning score did not have a statistically significant correlation within PDDS ≤ 2. None of the differences in convergent and concurrent validity between the BBS and DGI were significant. The additional variation in 6MWT explained by the DGI when added to a model with the BBS was 7.78% (95% CI: 0.6%, 15%). Conclusions: These exploratory analyses on data collected in pragmatic real-world settings suggest that neither of these measures of balance is profoundly superior to the other in terms of its concurrent and convergent validity. The DGI may not have any utility for people with PDDS ≤ 2, especially if the focus is on mobility, but may be useful if the goal is to provide insight on lower extremity endurance. Further research leveraging longitudinal data from pragmatic trials and quasi-experimental designs may provide more information about the clinical usefulness of the DGI in terms of its predictive validity when compared to the BBS.

Systematic review of the concurrent and predictive validity of MRI biomarkers in OA

The Portfolio Diet, a plant-based portfolio of cholesterol-lowering foods, has been shown to reduce low-density lipoprotein cholesterol (LDL-C), and other cardiovascular risk factors, in randomized controlled trials (RCTs). It is not known if these beneficial effects translate to a lower incidence OF cardiovascular disease (CVD). To support examinations between Portfolio Diet adherence and disease, a Portfolio Diet score (PDS) was developed and its predictive and concurrent validity was assessed within the Toronto Healthy Diet Study, a six-month RCT in overweight adults. Predictive validity was assessed using change in the PDS measured by food frequency questionnaire (FFQ) and concomitant change in LDL-C from baseline to six months using multiple linear regression, adjusted for potential confounders (n = 652). Concurrent validity was assessed in a subset of participants (n = 50) who completed the FFQ and a 7-day diet record (7DDR) at baseline. The PDS determined from each diet assessment method was used to derive correlation coefficients and Bland–Altman plots to assess the between-method agreement. The change in PDS was inversely associated with change in LDL-C (β coefficients: −0.01 mmol/L (95% confidence intervals (CIs): −0.02, −0.002; p = 0.02). The correlation between the PDS from the FFQ and 7DDR was 0.69 (95% CIs: 0.48, 0.85). The Bland–Altman plot showed reasonable agreement between the score from the FFQ and 7DDR. These findings indicate predictive validity of the PDS with lower LDL-C, and reasonable concurrent validity of the PDS as assessed by an FFQ against a 7DDR.

Concurrent and Predictive Validation of a Novel Robotic Surgery Simulator: A Prospective, Randomized Study

Concurrent and Predictive Validity of FRAIL-NH in Hospitalized Older Persons: An Exploratory Study

Internal Consistency and Validity of the Spanish Version of the St. George' Respiratory Questionnaire for Use in Patients With Clinically Stable Bronchiectasis