Nutritional screening within the GLIM procedure—Part 2: Operationalization of the concept risk of malnutrition using a modified Delphi procedure
Marian A. E. de van der Schueren, Elke Naumann, Rianne ter Bekke, Rocco Barazzoni, Renée Blaauw, Tommy Cederholm, Lee‐anne Chapple, Charlene Compher, M. Isabel T.D. Correia, Ryoji Fukushima, M. Cristina Gonzalez, Gordon L. Jensen, Charles Chin Han Lew, Su Lin Lim, Ainsley Malone, Veeradej Pisprasert, Elisabet Rothenberg, Alison Steiber, Martine Sealy, Harriët Jager‐WittenaarAbstract
Background and Aims
Within the original GLIM procedure (2019), the step on nutritional screening was not further elaborated. A new GLIM Risk of Malnutrition Working Group has recently developed a consensus‐based conceptual definition of “risk of malnutrition.” The present study aimed to operationalize this definition.
Methods
This study consisted of: (1) a literature search to identify risk factors for malnutrition, and (2) a two‐round online modified Delphi study. International professional experts ( n = 113) in the field of malnutrition were invited to rate the importance of identified risk factors using a 9‐point Likert scale. In questionnaire round 1, risk factors were rated “critically important” if ≥70% of the participants rated them 7–9, or “not important” if >30% rated them 1–3. The remaining risk factors were categorized as “undecided.” In questionnaire round 2, undecided risk factors were classified as “critically important” or “important, but not critical,” based on the same threshold.
Results
The literature search revealed 64 risk factors that were included in the Delphi questionnaires. Of 113 invited experts, 57 responded to Delphi Round 1, and 46 responded to Delphi Round 2. Twenty‐nine risk factors (from the overarching risk categories unintentional weight loss, nutrition impact symptoms, disease‐related factors, physical factors, psychological factors, decreased food intake, food assimilation, and poor diet) were deemed “critically important,” 10 “important, but not critical,” and 19 “substantially important.”
Conclusion
In this study, we identified which risk factors are considered critical to operationalize “risk of malnutrition.” Screening for risk of malnutrition should take these relevant risk factors into account.