A56 LEVELS OF AGREEMENT BETWEEN PATIENT AND PRACTITIONER LED MALUTRITION SCREENING TOOLS IN CIRRHOSIS
Notice bibliographique
Résumé
Malnutrition is prevalent in cirrhosis, and tools to screen for nutrition risk are available, however, screening is seldom implemented in clinical practice. Time constraints in a clinic setting may provide one explanation for this omission. Accurate, easy to use patient-led nutrition screening tools may increase use of nutrition screening. Research objectives: 1. To identify the agreement between a patient-led and health practitioner led nutrition-screening tool, the nutrition prioritizing tool (NPT). 2. To identify agreement between the patient led NPT and registered dietitian (RD) assigned gold-standard royal free hospital subjective global assessment score (RFH-SGA assessment tool). A cross-sectional survey and RD-led interview were completed on 68 patients with diagnosed cirrhosis from Edmonton and Calgary cirrhosis clinics and inpatients. Patients completed the online patient led NPT, and were subsequently interviewed by a research assistant and a RD to determine the practitioner led NPT and RFH-SGA gold standard assessment score. Proportions of patients in each category were examined and kappa measure of agreement analyses were conducted to identify if there was a statistically significant difference between assessment methods. See Table 1 for a comparison of the results from the 3 scales. Both the practitioner led NPT (Kappa = 0.37, p<0.001) and RFH-SGA (0.07, p=0.173) were not in agreement with the patient led NPT results. Considering that patients with any degree of nutrition risk should be referred for further assessment, all screens were collapsed into two categories, low risk and increased risk. While this did not improve the kappa levels the sensitivity of the patient led NPT compared to the RFH-SGA was 69% and the specificity was 87%. Many patients with cirrhosis (67% using RFH-SGA) would likely benefit from consultation with a RD. Patients in the 3 nutrition risk categories identified by the patient-led NPT screening tool were not in agreement with the practitioner led screening NPT categories or the gold-standard RFH-SGA, although the sensitivity and specificity of the test was acceptable. Further examination of other patient led measures with higher levels of agreement with the RFH-SGA is warranted. Table 1. Malnutrition scores on three different scales in cirrhosis NPT Nutrition prioritizing tool, RFH-SGA Royal free hospital-subjective global assessment None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».