Dietary Counselling Interventions in Malnutrition Research: Achieving an International Consensus on Best Practices Using an Amended Delphi Process
Bibliographic record
Abstract
INTRODUCTION: The evidence for the use of dietary counselling interventions in the management of malnutrition is inconsistent. Lack of consistency limits the ability to compare studies, impacting research, clinical practice and policy development. AIMS: To establish an international consensus on minimum requirements for dietary counselling interventions used for the prevention and management of malnutrition in adults in a clinical research context. METHODS: An international expert panel with seven members was formed. An amended Delphi study was conducted with 37 initial consensus statements generated from a targeted search of the literature. The agreement was assessed across two Delphi rounds and two online meetings. The full consensus was defined as the assignment of a score of 5 (strongly agree). A preliminary external validation was conducted with clinical and/or research dietetic professionals when delegates at the International Congress of Dietetics (ICD) 2021 voted during an online meeting on agreement with statements relating to patient assessment and delivery of a dietary counselling intervention. RESULTS: Consensus was achieved for 27 statements across four themes, with justifications and commentary. Minimum requirements included eight statements for 'nutritional assessment' (theme 1), seven for 'nutritional intervention content' (theme 2), five for 'nutritional intervention delivery' (theme 3) and seven for 'monitoring and follow-up' (theme 4). The ICD delegates voted on elements of assessment (77 of 140 delegates in agreement) and delivery of the intervention (37 of 101 delegates in agreement), demonstrating that consensus on these aspects of nutritional support interventions was low to moderate in this delegate sample. CONCLUSIONS: Consensus was achieved by an international group of experts to define the minimum essential factors for delivering dietary counselling interventions for the management of malnutrition in a research context; however, further external validation is required. The minimum requirements have the potential to influence research, clinical practice and policy development.
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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 | 0.401 | 0.290 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.011 | 0.006 |
| Science and technology studies | 0.006 | 0.009 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.004 | 0.023 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".