A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study

Introduction and aims The Self-Evaluation of Food Intake (SEFI®) is a simple tool to assess food intake that correlates well with the diagnosis of malnutrition in the hospital setting. Aims: to evaluate the validity of SEFI® for the diagnosis of malnutrition among adults in the primary care setting (primary aim); to assess the prevalence of malnutrition, the feasibility of the SEFI® and the variables associated with malnutrition (secondary aims). Methods A non-interventional prospective study on consecutive patients at three primary care practices. Primary endpoint: confrontation of a SEFI® visual analogue scale score <7/10 with the diagnosis of malnutrition as defined by the Global Leadership Initiative on Malnutrition criteria. Secondary endpoints: the proportion of patients for whom a SEFI® score was collected. Multivariate analysis: threshold α = 0.20 in univariate analyses, step-by-step logistic regression. Results Among 747 eligible patients, 505 were included: mean age (±SD) 56 ± 19 yrs, 61% female, 49% presenting with acute medical problems, 15.8% (n = 80) with SEFI® score <7/10, and 4.2% (n = 21) with malnutrition. The predictive performance of the SEFI® score <7 for the diagnosis of malnutrition was good (AUC = 0.82 [95% confidence interval (CI), 0.72–0.92]): sensitivity 76.2% (n = 16/21, [58.0–94.4]), specificity 86.8% (n = 420/484, [83.8–89.8]), positive predictive value 20.0% (n = 16/80, [11.2–28.8]), and negative predictive value 98.8% (n = 420/425, [97.8–99.8]). The feasibility of the SEFI® 10-point visual analogue scale was 100% (505/505). The variables independently associated with malnutrition were: female gender (odds ratio 4.9 [95% CI, 1.7–14.2], P = 0.003), cancer (4.8 [1.4–15.9], P = 0.011) and chronic alcohol consumption (7.4 [1.3–41.4], P = 0.023). Conclusions The prevalence of malnutrition was 4.2% in this primary care setting. The SEFI® visual analogue scale for food intake is feasible and could be helpful for the diagnosis of malnutrition in this setting.