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Journal of Cachexia, Sarcopenia and Muscle
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Development and validation of a Modified Patient‐Generated Subjective Global Assessment as a nutritional assessment tool in cancer patients

Authors: Zhenming Fu; Rui Zhang; Kun‐Hua Wang; Ming‐Hua Cong; Tao Li; Min Weng; Zeng‐Qing Guo; +10 Authors

Development and validation of a Modified Patient‐Generated Subjective Global Assessment as a nutritional assessment tool in cancer patients

Abstract

AbstractBackgroundCompleting Patient‐Generated Subjective Global Assessment (PG‐SGA) questionnaires is time consuming. This study aimed to develop and validate an easy‐to‐use modified PG‐SGA (mPG‐SGA) for cancer patients.MethodsSeventy professionals assessed the content validity, comprehensibility, and difficulty of the full PG‐SGA. A survey including the PG‐SGA and other questionnaires was completed by 34 071 adult hospitalized cancer patients with first cancer diagnosis or recurrent disease with any tumour comorbidities from the INSCOC study. Among them, 1558 patients were followed for 5 years after admission. Reliability and rank correlation were estimated to assess the consistency between PG‐SGA items and to select mPG‐SGA items. The external and internal validity, test–retest reliability, and predictive validity were tested for the mPG‐SGA via comparison with both the PG‐SGA and abridged PG‐SGA (abPG‐SGA).ResultsAfter deleting items that more than 50% of professionals considered difficult to evaluate (Worksheet 4) and items with an item‐total correlation <0.1, the mPG‐SGA was constructed. Nutritional status was categorized using mPG‐SGA scores as well‐nourished (0 points) or mildly (1–2 points), moderately (3–6 points), or severely malnourished (≥7 points) based on the area under curve (0.962, 0.989, and 0.985) and maximal sensitivity (0.924, 0.918, and 0.945) and specificity (1.000, 1.000, and 0.938) of the cut‐off scores. The external and internal validity and test–retest reliability were good. Significant median overall survival differences were found among nutritional status groups categorized by the mPG‐SGA: 24, 18, 14, and 10 months for well‐nourished, mildly malnourished, moderately malnourished, and severely malnourished, respectively (all Ps < 0.05). Neither the PG‐SGA nor the abridged PG‐SGA could discriminate the median overall survival differences between the well‐nourished and mildly malnourished groups.ConclusionsWe systematically developed and validated the mPG‐SGA as an easier‐to‐use nutritional assessment tool for cancer patients. The mPG‐SGA appears to have better predictive validity for survival than the PG‐SGA and abridged PG‐SGA.

Keywords

Adult, mPG‐SGA, QM1-695, Malnutrition, Nutritional Status, Reproducibility of Results, PG‐SGA, Nutritional assessment tool, Diseases of the musculoskeletal system, Nutrition Assessment, RC925-935, Patient‐generated subjective global assessment, Neoplasms, Human anatomy, Cancer patient, Humans, Original Articles: Clinical

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    popularity
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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
36
Top 10%
Top 10%
Top 10%
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Published in a Diamond OA journal