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. 2023 Jan 25;15(3):612.
doi: 10.3390/nu15030612.

Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study

José Manuel García-Almeida  1   2   3   4   5 , Cristina García-García  6   7 , María D Ballesteros-Pomar  8 , Gabriel Olveira  2   5   9   10   11 , Juan J Lopez-Gomez  12 , Virginia Bellido  13 , Irene Bretón Lesmes  14 , Rosa Burgos  15 , Alejandro Sanz-Paris  16   17 , Pilar Matia-Martin  18   19   20 , Francisco Botella Romero  21 , Julia Ocon Breton  22 , Ana Zugasti Murillo  23 , Diego Bellido  24
Affiliations

Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study

José Manuel García-Almeida et al. Nutrients. .

Abstract

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.

Keywords: Delphi; GRADE; clinical practice; feasibility; malnutrition; morphofunctional assessment.

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Conflict of interest statement

Persan Farma provided support for the present manuscript (funding, provision of study materials, medical writing and article processing charges).

Figures

Figure 1
Figure 1
This study was developed and coordinated by several groups (study coordinators, methodology coordinators, and the scientific committee). PICO (Patient, Intervention, Comparison, Outcome) framework was used to develop clinical questions to guide the literature review, ultimately developing GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations. A total of 37 statements were developed on 7 topics; these were evaluated in a Delphi method, achieving consensus on 26 statements.
Figure 2
Figure 2
Consensus achieved on each statement is shown by topic. Green indicates consensus, red indicates no consensus. CT, computed tomography; FS, functional status; S, statement; QoL, quality of life.
See this image and copyright information in PMC

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