Psychometric testing of the "Graz Malnutrition Screening Tool" (GMS) - Validity, Reliability, Sensitivity & Specificity
- D Eglseer1,
- AM Eisenberger1Email author,
- G Wirnsberger2 and
- RE Roller2
Published: 30 October 2015
Keywords
Background
Items of the Graz Malnutrition Screening Tool (GMS).
Item | Points |
|---|---|
1. Weight loss within the last 3 months | 0 to 2 points |
2. Body Mass Index | 0 to 2 points |
3. Changes in nutritional intake 3 separate questions: • loss of appetite • nausea/vomiting/diarrhea, • problems with chewing- and/or swallowing | 0 to 3 points |
4. Severity of disease | 0 to 2 points |
5. Age | 1 additional point for being ≥ 65 years |
Materials and methods
A cross-sectional study was conducted. Between December 2013 and April 2014, 404 randomly selected patients admitted to the University Hospital Graz were enrolled into the validation process. To collect valid data from patients of all age, participants were divided into three age groups (18-44; 45-69; 70+). For each patient enrolled, malnutrition was screened in independent and blinded fashion with GMS obtained by two trained dieticians. Additionally Nutritional Risk Screening (NRS) and MNA-SF for patients older than 70 was conducted. Statistical Analysis was performed using SPSS 20.
Results
According to the GMS 31.9%/28.5% of all admitted patients were categorized as malnourished (depending on rater). According to the reference standard NRS 24.5% suffered from malnutrition. Assuming the NRS as reference standard GMS reaches sensitivity of 90% and specificity of 87%. Pearson's r values of 0.78 according to the NRS and 0.84 according to the MNA-SF for patients older than 70 years show strong positive correlations. Inter-rater-reliability for the total scale was 0.82 (Cohen's kappa) which is considered almost perfect.
Conclusions
To improve patient safety in hospitals, patients with existing malnutrition have to be identified and treated according to evidence based standards. Regarding to psychometric testing, the GMS proves to be a valid and reliable malnutrition screening tool for hospitalized adult patients of all disease groups. It further provides increased sensitivity in older patients. GMS has already been introduced in the hospital software used in the province of Styria/Austria and may be technically transferred to different IT-systems.
Authors’ Affiliations
References
- Norman K, Pichard C, Lochs H, Pirlich M: Prognostic impact of disease-related malnutrition. Clin Nutr. 2008, 27 (1): 5-15.PubMedView ArticleGoogle Scholar
- Kondrup J, Allison SP, Elia M, Vellas B, Plauth M, Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN): ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003, 22 (4): 415-421.PubMedView ArticleGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
