Addressing disease-related malnutrition across healthcare settings: recent advancements and areas of opportunity
Bibliographic record
Abstract
Disease-related malnutrition (DRM) ensues when nutritional provision is inadequate to sustain physiologic requirements, which are often altered by disease and inflammation.It is observed across all care settings (acute, long-term, and community) around the globe, is prevalent (e.g., up to one in two adults and one in three children hospitalized in Canada), is associated with hospital readmission, decreased physical function, and mortality, and results in substantial economic burden to the health system (Allard et al. 2016;Curtis et al. 2017).Given that DRM is a known medical condition that negatively impacts patient and healthcare outcomes, strategies to eradicate this condition need to be implemented, with further research needed to evaluate their effectiveness, sustainability, and ultimately their impact on patient outcomes (Keller et al. 2021).The Canadian Malnutrition Task Force and the Canadian Nutrition Society have modelled best care practices and implementation strategies to foster improved malnutrition prevention, detection, and treatment across care settings over the past decade.For example, the Integrated Nutrition Pathway for Acute Care (INPAC) is a care pathway developed to guide nutrition risk screening, assessment, intervention, and transition of care in the hospital setting (Keller et al. 2015).The Primary Care Nutrition Pathway for Hospital to Community Transitions was developed to support the transition of patients at nutritional risk, or with malnutrition, from hospital to community (Keller et al. 2022).Globally, settingspecific initiatives with similar goals and content are being implemented (e.g., the Systematized, Interdisciplinary Malnutrition Program for impLementation and Evaluation (SIM-PLE) in Australia) (Bell et al. 2021).Even with similar efforts around the globe, policies to affect DRM care practice change are lacking.Internationally, there is increasing advocacy to recognize nutritional care as a human right to ensure that all persons with DRM have access to prompt screening, assessment, and intervention to optimize health (Cardenas et al. 2021).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.045 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.006 | 0.003 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.013 | 0.008 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.022 | 0.028 |
| Insufficient payload (model declined to judge) | 0.011 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".