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Use of Internal Validity in the Construct of an Index of Undernutrition
Author(s) -
Hall John C.
Publication year - 1990
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607190014006582
Subject(s) - malnutrition , medicine , incidence (geometry) , protein–energy malnutrition , enteral administration , anthropometry , parenteral nutrition , adverse effect , prospective cohort study , body mass index , intensive care medicine , physics , optics
An index of undernutrition (IOU) has been developed from a crosssectional study of 200 general surgical patients. The IOU was constructed using a ranking method based upon the relative values of anthropometric measurements (weight loss, mid‐arm muscle area, mid‐arm fat area) and serum protein concentrations (albumin, transferrin). The IOU was derived without reference to the incidence of adverse clinical events and took the form of a boolean cluster. A subsequent prospective longitudinal study evaluated the IOU in 367 general surgical patients at the time of admission to hospital. The results of this study supported the validity of the IOU. There was no association between gender and IOU scores. However, patients with high scores were more likely to be elderly (p < 0.02), have cancer (p < 0.001), stay in hospital longer (p < 0.001), or experience an adverse clinical event after surgery (p < 0.001). In accord with other published indices of undernutrition, the association between the extent of undernutrition and the incidence of adverse clinical events was only of moderate diagnostic potential (overall accuracy 68%). This study demonstrates that it is possible to derive an index of protein‐energy undernutrition that is independent of the incidence of adverse clinical events. (Journal of Parenteral and Enteral Nutrition 14: 582–587, 1990)