Key result
Clinical judgement of nutritional status by surgeons showed 77% concordance (kappa = 0.74, P<0.001) and correlated significantly with objective markers (R2 = 0.73, P<0.001).
Why the study?
Can surgeons reliably assess the nutritional status of surgical patients using clinical judgement?
Observational (n=64)
Can surgeons reliably assess the nutritional status of surgical patients using clinical judgement?
Effect estimate: kappa 0.74, R2 0.73
p-value: p=< 0.001
Surgeons can reliably assess the nutritional status of surgical patients using clinical judgement, which correlates well with objective laboratory markers.
Supports clinical judgement for nutritional screening in surgery; leaves open prospective outcome validation.
The ability of surgeons to make a reproducible and reliable evaluation of the nutritional status of patients was assessed. Three independent observers assigned 64 patients to one of four nutritional states--normal nourishment, and mild, moderate and severe malnutrition--using a questionnaire and clinical examination. Interobserver variability was analysed using the kappa statistic and reliability by assessing the correlation between the assigned class and total serum protein, haemoglobin, albumin, transferrin and cholesterol levels, weight loss and the results of immunological skin tests. Concordance was observed in 49 of the 64 judgements (77 per cent) and partial agreement in the remainder (kappa = 0.74, P < 0.001). Clinical judgement correlated significantly with albumin, transferrin and cholesterol levels and weight loss (R2 = 0.73, P < 0.001). Surgeons are able to assess nutritional status using clinical judgement.
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Lupo et al. (1993) conducted an observational in Surgical patients (n=64). Clinical judgement vs. Objective nutritional markers was evaluated on Interobserver variability and correlation with objective markers (kappa 0.74, R2 0.73, p=< 0.001). Clinical judgement of nutritional status by surgeons showed 77% concordance (kappa = 0.74, P<0.001) and correlated significantly with objective markers (R2 = 0.73, P<0.001).
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