Keller H H, Goy R, Kane S-L
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
Eur J Clin Nutr. 2005 Oct;59(10):1149-57. doi: 10.1038/sj.ejcn.1602225.
Nutrition risk screening for community-living seniors is of great interest in the health arena. However, to be useful, nutrition risk indices need to be valid and reliable. The following three studies describe construct validation, test-retest and inter-rater reliability of SCREEN II.
Study (1) seniors were recruited from the general community and from a geriatrician's clinic to complete a nutritional assessment and SCREEN II. 193 older adults provided medical and nutritional history, 3 days of dietary recall and anthropometric measurements. A dietitian reviewed all information collected and ranked seniors on risk: 1 (low) to 10 (high risk). Receiver operating characteristic curves were completed. An abbreviated SCREEN II was developed through statistical analysis and expert ranking of the 17 items. Studies (2) and (3) seniors were recruited from the community to self-administer (n = 149) or be interviewed (n = 97) using SCREEN II twice within 2 weeks. For self-administration one index was completed via mail. Interviewer administration was completed via telephone with two interviewers. Intra-class correlations were calculated.
(1) Total and abbreviated SCREEN II have increased sensitivity and specificity as compared to SCREEN I in identifying seniors at nutritional risk. (2) Test-retest reliability was adequate (intra-class correlation (ICC) = 0.83). (3) Inter-rater reliability was adequate (ICC = 0.83).
SCREEN II appears to be a valid and reliable tool for the identification of risk for impaired nutritional states in community-living older adults, and is an improvement over SCREEN I.
对社区老年人进行营养风险筛查在健康领域备受关注。然而，要使其有用，营养风险指数需要有效且可靠。以下三项研究描述了SCREEN II的结构效度、重测信度和评分者间信度。
研究（1）从普通社区和老年科诊所招募老年人，以完成营养评估和SCREEN II。193名老年人提供了医疗和营养史、3天饮食回顾及人体测量数据。一名营养师审查了所有收集到的信息，并根据风险将老年人分为1（低）至10（高风险）等级。绘制了受试者工作特征曲线。通过对17个项目进行统计分析和专家排序，开发了一个简化版的SCREEN II。研究（2）和（3）从社区招募老年人，让他们在2周内两次使用SCREEN II进行自我管理（n = 149）或接受访谈（n = 97）。自我管理时通过邮件完成一项指数。访谈管理通过电话由两名访谈者完成。计算组内相关性。
（1）与SCREEN I相比，完整版和简化版的SCREEN II在识别有营养风险的老年人方面具有更高的敏感性和特异性。（2）重测信度良好（组内相关性（ICC）= 0.83）。（3）评分者间信度良好（ICC = 0.83）。
SCREEN II似乎是一种有效且可靠的工具，可用于识别社区居住老年人营养状态受损的风险，并且是对SCREEN I的改进。
