1.Validation Of Nutrition Screening Tool: Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) For Chronic Liver Disease Patients
Norashimah Rajab ; Syahrul Bariah Abdul Hamid ; Aishah Hanum Mohd Said ; Khairil Anuar Md Isa
Malaysian Journal of Medicine and Health Sciences 2023;19(No.3):130-137
Introduction: Hepatic diseases patients are especially prone to malnutrition, which is often underestimated. Screening tools were developed to detect the risk of malnutrition. However, screening tools for patients with liver disease
were frequently underestimated. Fluid overload is the main issue to perform nutritional screening in liver disease patients. Therefore, this study aimed to validate the Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) among
patients and to evaluate association between RFH-NPT, Nutritional Risk Screening (NRS 2002) and Subjective Global
Assessment (SGA). Methods: This cross sectional study was conducted in 3 phases; transcultural adaptation, criterion
validity and reliability phases. Content validity was confirmed by interviewing eight liver disease professionals. Face
validity was assessed by surveying forty nurses working in the liver disease ward. In addition, agreement between
NRS 2002 and RFH-NPT assessment was assessed using the SGA tool. Results: Eighty patients with liver disease took
part in this study. The SGA assessment found malnutrition in 75% of patients (95% CI, 60%–95%) while 80% (95%
CI, 65%-80) were found as at risk of malnutrition using RFH- NPT. Moderate specificity and high sensitivity of RFHNPT were 97% and 74%, respectively, and 95% positive predictive value was measured. Conclusion: The RFH-NPT
nutritional screening tool is the initial and most reliable in this population to assess the malnutrition risk. Thus, inclusion of the RFH-NPT with NRS 2002 demonstrated positive and a fair agreement between the SGA and RFH-NPT
tool to be used as a routine nutrition screening protocol for identifying patients at risk of malnutrition.