Abstract

Background and objectiveThe newly developed Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.DesignCross-sectional study.MethodsThe study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity + specificity–1).ResultsAccording to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.ConclusionsThe suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

Highlights

  • Background and objectiveThe newly developed Minimal Eating Observation and Nutrition Form Á Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA)

  • According to the previously suggested cutoff scores of the MEONF-II, 41% were at moderate/high UN risk; according to the MNA, 50% were at risk for/ already undernourished (Table 1)

  • According to the Youden index, the optimal cut-off point for identifying those at any nutritional risk was !2 points, with an area under the curve (AUC) of 0.80 (Table 2)

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Summary

Introduction

Background and objectiveThe newly developed Minimal Eating Observation and Nutrition Form Á Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). The suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (!2 and !4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J 0sensitivity'specificityÁ1). The lower cut-off for MEONF-II, used to identify any level of risk for UN (!2; J 00.52) gave an overall accuracy of 76% and the AUC was 80%. Conclusions: The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use

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