Development and Preliminary Validation of a Novel Protein Assessment Screening Tool (PAST) for Nutrition Care

Background/Objectives. Protein needs increase with aging to support muscle health. These needs are further increased in older adults undergoing surgery, particularly in procedures limiting acute post-operative activity, such as total joint arthroplasty (TJA). However, tools to efficiently characterize dietary protein intake in clinical settings have remained undeveloped. This report describes the initial development and preliminary validation of a novel protein screener (Protein Assessment Screening Tool, PAST) for community-dwelling adults and a clinical population undergoing elective total joint arthroplasty (TJA). Methods. Participants (n = 48; 33 female, 15 male) were aged 40-70 years in the community-dwelling group (n = 22) and aged 50-70 years in the elective TJA group (n = 26). Both groups completed a 3-day food record and the PAST at two timepoints. Descriptive statistics were performed on demographic data. Differences between male and female participants and between groups were determined using independent t-tests or Mann-Whitney U tests as appropriate. The screener and 3-day food records were compared to determine sensitivity, specificity, and negative and positive predictive values (NPVs and PPVs), with a threshold of ≥1.2 g/kg/day representing adequate protein intake. Results. The PAST had relatively high sensitivity (78-87%) and PPVs (68-79%) but lower and more variable specificity (25-57%) and NPVs (33-57%); however, the 95% confidence intervals indicated variability. Conclusions. These preliminary findings demonstrate the potential clinical utility of the PAST. However, additional research is required to validate this tool prior to broad implementation in clinical practice.