AND/ASPEN and the GLIM malnutrition diagnostic criteria have a high degree of criterion validity and reliability for the identification of malnutrition in a hospital setting: A single‐center prospective study

Abstract Background Multiple malnutrition diagnostic tools are available in clinical practice, yet, evidence on their validity and reliability is limited. We aim to assess and compare the validity and reliability of the different combinations of indicators of the three most used diagnostic tools with two validated malnutrition screening tools. Methods Nutrition risk screening was evaluated using the Mini Nutritional Assessment–Short Form (MNA‐SF) and the Nutrition Risk Screening‐2002 (NRS‐2002). Nutrition assessment was conducted using different combinations of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN), the European Society for Clinical Nutrition and Metabolism (ESPEN), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Concurrent criterion validity and inter‐rater reliability of the overall and the different combinations of indicators in the diagnostic tools were evaluated and compared. Sensitivity, specificity, positive predictive value, negative predictive value, and Cohen kappa were calculated to determine tool validity and reliability. Results The AND/ASPEN (132 [22.8%]) combination and GLIM‐1 (133 [23.0%]) (weight loss + compromised food intake) predicted the highest number of malnourished patients and reported a high degree of concurrent criterion validity, agreement, and reliability. On the contrary, overall ESPEN (using any combination) and GLIM‐2 (reduced body mass index [BMI] + compromised food intake) reported only moderate criterion validity and low agreement and reliability. Conclusion Different combinations of diagnostic criteria led to varying validity and reliability, with the lowest validation results rising from the combinations of indicators using BMI as a criterion for malnutrition diagnosis.