Malnutrition ‘self-screening’ with ‘MUST’ in hospital outpatients: concurrent validity and the ease of use

Abstract

A 19.6% of patients categorised themselves into medium (9.8 %) and high risk (9.8 %) of malnutrition. For the three-category classification of ‘MUST’ (low, medium and high risk) agreement between patient ‘self-screening’ and health-care professional screening was 90 % ( k= 0.70 (within the range of 0.45–0.75 indicative of ‘fair-good’ agreement); SE 0.058; P < 0.001). For two categories (low risk and medium + high risk) agreement was 93 % ( k= 0.78 (within the range of 0.75–1.0, indicative of ‘excellent’ agreement); SE 0.058; P < 0.001). Disagreements between the two methods were not systematically under or over categorised. Of the 14 (7 %) discrepancies associated with the two category classification, five were associated with BMI score, seven with weight loss score and one with acute disease score (one was associated with both weight loss and acute disease effect score). Most patients reported that they were able to complete ‘self-screening’ in less than 5 min (71 %), overall 98 % were able to complete in less than 10 min. Patients found the tool easy or very easy to understand (96%) and complete (98%), with 94 % reporting that they were happy to screen themselves. The mean recorded time for patients to complete screening was 5 min (SD 1 min 54 s). This study of patients attending hospital outpatient clinics shows that ‘self-screening’ involving ‘MUST’ is acceptable to patients, user friendly and with good concurrent validity to health-care professional screening. Further work is required to understand how ‘selfscreening’ and subsequent management can be effectively implemented into routine outpatients, and the wider community.