Nutritional screening for improving professional practice for patient outcomes in hospital and primary care settings

Amir-Houshang Omidvari; Yasaman Vali; Susan M Murray; David Wonderling; Arash Rashidian

doi:10.1002/14651858.CD005539.pub2

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Flowchart of search process.

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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Summary of findings 1. Summary of findings

Study ID	Outcomes	Before						After						Comments
Study ID	Outcomes	Control group (mean)	N	Intervention group (mean)	N	Difference (95% CI)	P Value	Control group (mean)	N	Intervention group (mean)	N	Difference (95% CI)	P Value	Comments
Moore 1997	General health score	57	112	61	149	4(‐3 to 10)	0.31	70	99	69	131	‐1(‐8 to 4)	0.53
	Nutrition problems detection rate (%)	NR^#						5	112	5	149	0(‐1 to 1)	0.98
	Nutritional intervention rate (%)	NR						4	112	4	149	0(‐4 to 4)	0.84
Study ID	Outcomes	Control group (%)	N	Intervention group (%)	N			Control group (%)	N	Intervention group (%)	N	Difference (95% CI)	P Value
Jordan 2003	Dietitian referrals	18.5	27	15.2	46	‐3.3		10.5	38	9.4	64	‐1.1
Jordan 2003	Incidence of weight documentation	29.6	27	26	46	‐3.6		7.9	38	72	64	64.1
Study ID	Outcomes	Control group	N	Intervention group	N	Difference (95% CI)	P Value	Control group	N	Intervention group	N	Difference (95% CI)	P Value
Rypkema 2003	Length of stay (days ‐ mean)	NR						32.7	158	31.1	140	1.6	0.51
	Weight change (Kg ‐ mean)	NR						‐0.76	140	0.92	105	1.68	<0.001
	Number of patient with >3% weight loss	NR						42	140	11	105	‐19%	<0.001
	Number of nosocomial infections	NR						58	158	33	140	‐13%	0.01
	Number of patients with pressure sores	NR						33	158	23	140	‐0.4%	0.37
	Mean hospital cost per patient (Euro)*	NR						7908	158	7516	140	‐392 (‐1619 to 835)
# NR: Not Reported. *Costs were compared by measuring time spent on training and extra time needed for screening monitoring and intervening in the intervention group; materials used, such as diagnostic tests for infection and supplements, in control and intervention group; and number of in‐hospital days for both groups. No discounting has been performed, as the study duration is less than one year. No price year was mentioned.

Summary of findings 1. Summary of findings

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Table 1. General description of included studies

ID	Title	Study design	Country	Setting	Intervention	Study period			Participants		Main relevant outcomes
ID	Title	Study design	Country	Setting	Intervention	Pre	Intervention	Post	Intervention group	Control group	Main relevant outcomes
Moore 1997	A Randomized Trial of Office‐based Screening for common Problems in Older Persons	Randomised Controlled Trial	USA	Community, general practice	Comprehensive health problem screening	Not stated in the text			patients >70yrs, English speaking, not acutely or terminally ill,able to answer questions visiting their physicians for a new visit or physical examination		1.Ferequency of nutrition problems detection and 2.Intervention as a result of detection of nutrition problems
Moore 1997		Randomised Controlled Trial	USA	Community, general practice	Comprehensive health problem screening	Not stated in the text			112	149
Jordan 2003	Introducing a nutrition screening tool: an exploratory study in a district general hospital	Quasi experimental, Controlled before‐after study	UK	Hospital	Nutritional Screening	May 1999	November 1999	January 2000	All patients admitted during study periods and able to give informed consent		1.Nursing documentation, 2.patient care at mealtime and 3.referral to dietitian
Jordan 2003		Quasi experimental, Controlled before‐after study	UK	Hospital	Nutritional Screening	May 1999	November 1999	January 2000	May:46 Jan:27	May:64 Jan: 38
Rypkema 2003	Cost‐effectiveness of an interdisciplinary intervention in geriatric inpatients to prevent malnutrition	Prospective controlled trial plus a cost‐consequence study	Netherlands	Hospital	Nutritional Screening	2001			non‐terminally ill,60yr old inpatients of geriatric ward of two different hospitals who admitted for more than 2 and less than 150 days		1.Lenght of stay, 2.Weight change, more than 3% 3.Weight loss, 4.Pressure sores, 5.Nosocomial infection 6.Total hospital cost per patient
Rypkema 2003		Prospective controlled trial plus a cost‐consequence study	Netherlands	Hospital	Nutritional Screening	2001			140	158

Table 1. General description of included studies

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