Makelarski Jennifer A, Abramsohn Emily, Benjamin Jasmine H, Du Senxi, Lindau Stacy Tessler
Jennifer A. Makelarski, Emily Abramsohn, Senxi Du, and Stacy Tessler Lindau are with Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL. Stacy Tessler Lindau is also with Department of Medicine-Geriatrics, University of Chicago. Jasmine H. Benjamin is with the Department of Political Science, University of Chicago.
Am J Public Health. 2017 Nov;107(11):1812-1817. doi: 10.2105/AJPH.2017.304033. Epub 2017 Sep 21.
To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener.
We conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories).
Food insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI] = 65%, 85%) and 72% (95% CI = 57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI = 86%, 98%; P = .002]; 30-day: 92% [95% CI = 79%, 98%; P = .02]).
The AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications. Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool.
检验美国儿科学会（AAP）推荐的粮食不安全筛查工具的诊断准确性。
2016年7月至11月在伊利诺伊州芝加哥进行前瞻性诊断准确性研究。我们从成人和儿科急诊科招募了便利样本的成年人（12个月回顾性研究：n = 188；30天回顾性研究：n = 154）。一份自填式调查问卷包括6项家庭粮食安全筛查（金标准）、经过验证的2项饥饿生命体征（HVS；经常、有时、从不反应类别）以及2项AAP工具（是或否反应类别）。
粮食不安全情况普遍存在（12个月回顾组：46%；30天组：39%）。使用12个月和30天回顾时，AAP工具的敏感性分别为76%（95%置信区间[CI] = 65%，85%）和72%（95%CI = 57%，84%）。HVS的敏感性显著高于AAP工具（12个月：94%[95%CI = 86%，98%；P = .002]；30天：92%[95%CI = 79%，98%；P = .02]）。
AAP工具遗漏了近四分之一在医院筛查出的粮食不安全成年人；HVS筛查工具更敏感。对公共卫生的影响。采用粮食不安全筛查的医疗保健系统应优化筛查工具的易用性和敏感性。
