Global Leadership Initiative on Malnutrition Criteria as a Nutrition Assessment Tool for Cancer Patients in China: How and What

Abstract

Background: Since the launch of the Global Leadership Initiative on Malnutrition (GLIM) core consensus, there has been an urgent need to validate the newly released framework criteria among cancer patients. To determine 4 questions about the performance of the GLIM system in the nutrition assessment of cancer patients. Methods: This multicenter retrospective study compared the GLIM, various combinations of the GLIM, the GLIM with or without the NRS-2002, and the GLIM based on the Malnutrition Screening Tool (MST) or the Age, Intake, Weight and Walk (AIWW) screening tool against the scored Patient-Generated Subjective Global Assessment (sPG-SGA) in 8 patient subgroups. Findings: By applying the GLIM, 49.1% of 3777 cancer patients were diagnosed with malnutrition. Compared with the sPG-SGA, the GLIM presented moderate consistency (k= 0.54; P <0.001), fair sensitivity (70.5%) and specificity (88.3%), moderate diagnostic value (AUCROC of 0.79). The “weight loss and cancer” combination showed better performance than other phenotypic combinations. The GLIM without screening increased the sensitivity but decreased the specificity. The performance of MST-GLIM and AIWW-GLIM were as good as the NRS2002-GLIM. Interpretation: GLIM criteria have moderate consistency in comparison with the sPG-SGA, taking this together with less items and easier to use, we drew the conclusion that the GLIM is therefore not inferior to sPG-SGA in the nutrition assessment of patients with cancer. The “weight loss and cancer” was the best combination. Risk screening should be done before GLIM diagnosis and the NRS 2002, MST or AIWW can be used as the screening tool. Funding Statement: This work was supported by the National Key Research and Development Program (to Dr. Hanping Shi; No.2017YFC1309200). Declaration of Interests: All authors have completed the ICMJE uniform disclosure form (www.icmje.org/coi_disclosure.pdf) and declare that they have no conflicts of interest. Ethics Approval Statement: The participating institutions that provided the data had passed a review by their institutional review boards and obtained ethical approval from the ethics committees of the academic hospitals. Informed consent was obtained from each participant.