O'Connor Jackie, van Veenendaal Nicholas, Gallo Rebecca, Griffin Hilda
Clinical Nutrition Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Nutr Diet. 2025 Apr;82(2):163-171. doi: 10.1111/1747-0080.12917. Epub 2024 Dec 8.
The aim of this study was to assess the criterion validity of the Global Leadership Initiative on Malnutrition criteria compared to the subjective global assessment in a diverse inpatient population.
This cross-sectional study was a retrospective analysis of point prevalence audit data. The prevalence of malnutrition determined by the Global Leadership Initiative on Malnutrition criteria was compared to the Subjective Global Assessment. Validity statistics were determined using all of the Global Leadership Initiative on Malnutrition criteria concurrently as well as each pair that could be used to diagnose malnutrition. Subgroup analysis was undertaken based on severe malnutrition, treatment group, age and body mass index.
Nine hundred and eighty-one patients were included (65.1 ± 18.6 years, 54.8% male). The prevalence of malnutrition was 36.7% using the Subjective Global Assessment and 36.1% using the Global Leadership Initiative on Malnutrition criteria. More patients were classified as severely malnourished using the Global Leadership Initiative on Malnutrition criteria (9.8% vs. 6.0%), whilst more rehabilitation patients were classified as malnourished using the Subjective Global Assessment (42.2% vs. 33.6%). The criterion validity of the Global Leadership Initiative on Malnutrition criteria was good, with a sensitivity of 92.5% (95% CI 90.9-94.2) and specificity of 96.6% (95% CI 95.5-97.8). There was a downward trend in sensitivity with increasing body mass index and a lower sensitivity in the rehabilitation population. The criterion validity was fair at best when each pair of the Global Leadership Initiative on Malnutrition criteria was considered independently of other criteria.
When all criteria are considered concurrently, the Global Leadership Initiative on Malnutrition criteria present good criterion validity and can be applied in clinical practice to diagnose malnutrition.
本研究旨在评估在不同住院患者群体中，与主观全面评定相比，营养不良全球领导力倡议标准的标准效度。
这项横断面研究是对时点患病率审核数据的回顾性分析。将营养不良全球领导力倡议标准确定的营养不良患病率与主观全面评定进行比较。使用所有营养不良全球领导力倡议标准同时以及可用于诊断营养不良的每一对标准来确定效度统计数据。基于严重营养不良、治疗组、年龄和体重指数进行亚组分析。
纳入981例患者（年龄65.1±18.6岁，男性占54.8%）。主观全面评定法得出的营养不良患病率为36.7%，营养不良全球领导力倡议标准得出的患病率为36.1%。使用营养不良全球领导力倡议标准时，更多患者被归类为严重营养不良（9.8%对6.0%），而使用主观全面评定法时，更多康复患者被归类为营养不良（42.2%对33.6%）。营养不良全球领导力倡议标准的标准效度良好，敏感性为92.5%（95%置信区间90.9 - 94.2），特异性为96.6%（95%置信区间95.5 - 97.8）。随着体重指数增加，敏感性呈下降趋势，且康复人群中的敏感性较低。当单独考虑营养不良全球领导力倡议标准的每一对标准而不考虑其他标准时，标准效度充其量为中等。
当同时考虑所有标准时，营养不良全球领导力倡议标准具有良好的标准效度，可应用于临床实践中诊断营养不良。
