A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study

Introduction and aims: The Self-Evaluation of Food Intake (SEFI (R)) is a simple tool to assess food intake that correlates well with the diagnosis of malnutrition in the hospital setting. Aims: to evaluate the validity of SEFI (R) for the diagnosis of malnutrition among adults in the primary care setting (primary aim); to assess the prevalence of malnutrition, the feasibility of the SEFI (R) and the variables associated with malnutrition (secondary aims). Methods: A non-interventional prospective study on consecutive patients at three primary care practices. Primary endpoint: confrontation of a SEFI (R) visual analogue scale score <7/10 with the diagnosis of malnutrition as defined by the Global Leadership Initiative on Malnutrition criteria. Secondary endpoints: the proportion of patients for whom a SEFI (R) score was collected. Multivariate analysis: threshold alpha = 0.20 in univariate analyses, step-by-step logistic regression. Results: Among 747 eligible patients, 505 were included: mean age (+/- SD) 56 +/- 19 yrs, 61% female, 49% presenting with acute medical problems, 15.8% (n = 80) with SEFI (R) score <7/10, and 4.2% (n = 21) with malnutrition. The predictive performance of the SEFI (R) score <7 for the diagnosis of malnutrition was good (AUC = 0.82 [95% confidence interval (CI), 0.72-0.92]): sensitivity 76.2% (n = 16/21, [58.0-94.4]), specificity 86.8% (n = 420/484, [83.8-89.8]), positive predictive value 20.0% (n = 16/80, [11.2-28.8]), and negative predictive value 98.8% (n = 420/425, [97.8-99.8]). The feasibility of the SEFI (R) 10-point visual analogue scale was 100% (505/505). The variables independently associated with malnutrition were: female gender (odds ratio 4.9 [95% CI, 1.7-14.2], P = 0.003), cancer (4.8 [1.4-15.9], P = 0.011) and chronic alcohol consumption (7.4 [1.3-41.4], P = 0.023). Conclusions: The prevalence of malnutrition was 4.2% in this primary care setting. The SEFI (R) visual analogue scale for food intake is feasible and could be helpful for the diagnosis of malnutrition in this setting. (C) 2020 Published by Elsevier Ltd.

Automated summary

This study found a prevalence of malnutrition of 4.2% in a primary care setting, with the SEFI (R) tool showing good predictive performance for diagnosing malnutrition. Factors independently associated with malnutrition included female gender, cancer, and chronic alcohol consumption.