BACKGROUND Malnutrition screening relies on quick and easy-to-use tools that require minimal training of users. Valid and reliable tools should avoid under-referral of adults with a malnutrition diagnosis or over-referral of those without a malnutrition diagnosis to dietitians. OBJECTIVE Our aim was to conduct a systematic review of adult malnutrition screening tools for validity, agreement, and reliability, and to determine the costs of the malnutrition screening procedure. METHODS Following a structured process, a comprehensive search using PubMed, MEDLINE, EMBASE, and CINAHL was conducted for relevant research published between 1997 and 2017 that examined the validity, agreement, reliability, and costs of nutrition screening tools. RESULTS Sixty-nine studies met the inclusion criteria. The Malnutrition Screening Tool exhibited moderate validity, agreement, and reliability based on Grade I (Good/Strong) evidence. The evidence supporting the conclusions for the remaining tools was Fair (Grade II). The Malnutrition Universal Screening Tool exhibited high validity and moderate agreement and reliability. The Mini Nutritional Assessment-Short Form exhibited moderate validity and reliability and low agreement. The Short Nutritional Assessment Questionnaire and the Nutrition Risk Screening 2002 exhibited moderate validity and reliability and the Mini Nutritional Assessment-Short Form Body Mass Index exhibited high validity and moderate agreement. However, these last three tools were missing reliability or agreement data. Limited data were available to evaluate malnutrition screening costs. CONCLUSIONS This review provides an analysis of validity, agreement, and reliability of tools to screen adults for malnutrition, regardless of their age, medical history, or location. No tools were found with high validity, reliability, and strong supportive evidence. Tools most often achieved moderate validity, agreement, and reliability, and had large variations in individual results. The minimum validity and reliability of tools to screen adults for malnutrition should be established to shape future research. Cost data for the screening process should be obtained and examined.

中文翻译：

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成人营养不良（营养不良）筛查：证据分析中心系统评价

背景营养不良筛查依赖于对用户进行最少培训的快速且易于使用的工具。有效和可靠的工具应避免将营养不良诊断的成年人转诊不足或将没有营养不良诊断的成年人转诊给营养师。目标 我们的目标是对成人营养不良筛查工具的有效性、一致性和可靠性进行系统评价，并确定营养不良筛查程序的成本。方法 按照结构化流程，使用 PubMed、MEDLINE、EMBASE 和 CINAHL 对 1997 年至 2017 年间发表的相关研究进行了全面搜索，这些研究检查了营养筛查工具的有效性、一致性、可靠性和成本。结果 69 项研究符合纳入标准。营养不良筛查工具表现出中等有效性，一致性和基于 I 级（好/强）证据的可靠性。支持其余工具结论的证据为一般（II 级）。营养不良通用筛查工具表现出高有效性和中等一致性和可靠性。Mini Nutritional Assessment-Short Form 表现出中等的有效性和可靠性以及低一致性。简短营养评估问卷和 2002 年营养风险筛查显示出中等的有效性和可靠性，而迷你营养评估-简短形式的体重指数显示出高有效性和中等一致性。但是，这最后三个工具缺少可靠性或一致性数据。可用于评估营养不良筛查成本的数据有限。结论 本次审查对有效性、一致性、筛查成人营养不良的工具的可靠性和可靠性，无论他们的年龄、病史或地点如何。没有发现具有高有效性、可靠性和强有力的支持证据的工具。工具最常达到中等的有效性、一致性和可靠性，并且个体结果差异很大。应建立筛查成人营养不良的工具的最低有效性和可靠性，以塑造未来的研究。应获取和检查筛选过程的成本数据。应建立筛查成人营养不良的工具的最低有效性和可靠性，以塑造未来的研究。应获取和检查筛选过程的成本数据。应建立筛查成人营养不良的工具的最低有效性和可靠性，以塑造未来的研究。应获取和检查筛选过程的成本数据。