Validity of nutritional screening tools for hospitalized children

Background. Malnutrition in hospitalized children can be prevented if children with risk of malnutrition are identified. Every hospital is recommended to have a standard nutritional screening tool. Numerous simple screening tools have been developed, namely Paediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), and Screening Tool for Risk on Nutritional Status and Growth (STRONG-kids). None has been accepted as a universal tool. Our study aims to determine the best screening tools compared to Subjective Global Nutrition Assessment (SGNA), an assessment tool which is more complex as our gold standard. Methods. This diagnostic study involved 116 patients aged 1-15 years. Three screening tools and SGNA were examined to each subject. Statistical analysis was used to determine sensitivity, specificity, and likelihood ratio (LR) by results from screening tools divided into low and moderate-high risk of malnutrition compared to results from SGNA divided into no and moderate-severe malnutrition. Results. PYMS showed superior agreement to SGNA resulting in sensitivity 95.32%, specificity 76.92%, positive LR 4.13, and negative LR 0.061. STAMP resulted in sensitivity, specificity, positive LR, and negative LR, respectively, as 100%, 11.54%, 1.13, and 0 and STRONG-kids resulted in 100%, 7.7%, 1.083, and 0. Conclusion. PYMS was the most reliable screening tool.