The Development and Evaluation of an Alternative Abbreviated Nutrition Risk Screening Tool Using Item Response Theory

Area of Science:

• Gerontology
• Nutritional Science
• Biostatistics

Background:

• Brief nutrition risk screening tools are essential for clinical and community settings.
• The existing SCREEN-8 tool may overestimate nutrition risk in older adults.
• There is a need for a more specific, abbreviated nutrition screening tool.

Purpose of the Study:

• To identify the optimal subset of items from SCREEN-14 to create a brief, valid nutrition risk screening tool for older adults.
• To develop and evaluate an 8-item version of the Seniors in the Community Risk Evaluation for Eating and Nutrition (SCREEN) tool using Item Response Theory (IRT).

Main Methods:

• Analysis of data from 20,093 participants who completed an online version of SCREEN-14.
• Application of Item Response Theory (IRT) with the Graded Response Model to identify an 8-item subset.
• Comparison of item sets for all participants and those aged 75 years and older.

Main Results:

• The new 8-item SCREEN-IRT tool identified 27.7% of adults at nutrition risk, compared to 42.1% identified by SCREEN-8.
• Both SCREEN-IRT and SCREEN-8 demonstrated acceptable model fit.
• The developed SCREEN-IRT tool comprises different items than SCREEN-8.

Conclusions:

• A novel 8-item nutrition risk screening tool (SCREEN-IRT) was developed using IRT.
• SCREEN-IRT demonstrates improved specificity by identifying a lower proportion of older adults at nutrition risk.
• Further research is required to establish the criterion validity of SCREEN-IRT.