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Validation of a Nutritional Screening Tool for Ambulatory Use in Pediatrics
Gal Rub1, Luba Marderfeld, Irit Poraz
1*Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel †Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Clalit Health Services, Petah Tikva ‡Faculty of Agriculture, Food and Environmental Sciences, The Hebrew University, Rehovot §National Management Office, Clalit Health Services, Tel Aviv ||Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv ¶Netka Pediatric Community Center, Tel Aviv #Plotkin Pediatric Community Center, Tel Aviv, Clalit Health Services, Israel.
Insights
Modified Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) improved pediatric malnutrition risk assessment in primary care. Its use increased clinician awareness of children's nutritional status.
Area of Science:
- Pediatric Nutrition
- Primary Health Care
- Nutritional Screening Tools
Background:
- Malnutrition in children poses a significant public health challenge.
- Effective screening tools are crucial for early detection and intervention in primary care settings.
- The Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) is designed for pediatric nutritional assessment.
Purpose of the Study:
- To evaluate the utility of the STAMP in a community-based primary health care clinic.
- To assess the impact of STAMP implementation on healthcare professionals' awareness of pediatric nutritional status.
- To compare the effectiveness of the standard STAMP with a modified version.
Main Methods:
- The STAMP tool was applied in its original and modified forms in an ambulatory setting.
- Nutritional risk identified by STAMP was compared against a registered dietitian's comprehensive assessment.
- Documentation of nutrition-related data and anthropometric measurements in patient records was analyzed pre- and post-STAMP implementation.
Main Results:
- The modified STAMP demonstrated a substantial agreement (κ=0.57) with dietitian assessments, showing improved sensitivity (76.19%) and specificity (82.05%).
- The original STAMP showed fair agreement (κ=0.47) with lower sensitivity (47.62%).
- Implementation of STAMP led to increased recording of appetite, dietary intake, and anthropometric measurements.
Conclusions:
- Modifying the STAMP enhances its accuracy for evaluating nutritional risk in community primary care.
- Utilizing the STAMP in primary care settings effectively increases clinician awareness of children's nutritional status.
- Further research is needed to determine if STAMP implementation leads to reduced malnutrition rates and improved pediatric care.
Objectives:
To evaluate the use of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in a primary health care clinic in the community and to assess the impact of its use on medical staff's awareness of nutritional status.
Methods:
STAMP scoring system was tested as is and with modifications in the ambulatory setting. Nutritional risk according to STAMP was compared with a detailed nutritional assessment performed by a registered dietitian. Recording of nutrition-related data and anthropometric measurements in medical files were compared prior and post implementation.
Results:
Sixty children were included (31 girls, 52%), ages between 1 and 6 years, mean age 2.8 ± 1.5 (mean ± SD). STAMP scores yielded a fair agreement between STAMP and the dietitian's nutritional assessment: κ = 0.47 (95% confidence interval [CI] 0.24-0.7), sensitivity of 47.62% (95% CI 28.34-67.63). Modified STAMP yielded more substantial agreement: κ = 0.57 (95% CI 0.35-0.79), sensitivity of 76.19% (95% CI 54.91-89.37), specificity of 82.05% (95% CI 67.33-91.02). The use of STAMP resulted in an increase in recording of appetite, dietary intake, and anthropometric measurements.
Conclusions:
Modification of the STAMP improved nutritional risk evaluation in community setting. The use of STAMP in a primary health care clinic raised clinician's awareness to nutritional status. Further work will identify whether this could be translated into lower malnutrition rates and better child care.
