Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

Reliability of patient-led screening with the Malnutrition Screening Tool (MST):  agreement between patient and health professional scores in the cancer care ambulatory setting (#358)

Alexandra Di Bella 1 , Claire Blake 1 , Adrienne Young 1 , Anita Pelecanos 2 , Teresa Brown 1
  1. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
  2. Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia


Malnutrition prevalence in cancer patients is reported as high as 80%, and is associated with lower survival, reduced response to treatment and poorer performance status. The Malnutrition Screening Tool (MST) is a validated tool when administered by a health professional; however, has not been validated for patient-led screening.


This study aims to validate patient-led MST screening though assessing inter-rater reliability between patient and dietitian-researcher led screening and intra-rater reliability between an initial and repeat patient screening.


Cross-sectional. Participants: 208 adults attending ambulatory cancer care services in a metropolitan teaching hospital in Queensland, Australia (n=160 inter-rater reliability; n=48 intra-rater reliability using a separate sample).

Main outcome measurements:

MST risk categories (MST 0-1: not at risk, MST ≥2: at risk) as determined by screening completed by patients and dietitian-researcher, and patient test-retest screening; patient acceptability.

Statistical analysis:

Percent and chance-corrected agreement (Cohen’s kappa coefficient, κ) were used to determine agreement between patient-MST and dietitian-MST (inter-rater reliability) and patient-MSTA and patient-MSTB (intra-rater reliability).


High inter-rater reliability and intra-rater reliability was observed. Percent agreement between patient-MST and dietitian-MST was 96%, with “almost perfect” chance adjusted agreement (κ = 0.92, 95% CI 0.84 – 0.97, P<0.001). Percent agreement between repeated patient-MSTA and patient-MSTB was 94%, with “almost perfect” chance-adjusted agreement (κ = 0.88, 95% CI 0.71 – 1.00, P<0.001). Based on dietitian-MST, 32% (n=53) were identified at risk of malnutrition, and 40% of these reported not seeing a dietitian.  Of 156 patients who provided feedback, almost all reported that the MST was clear (92%), questions easy to understand (95%) and took <5 minutes to complete (99%).


Patient-led MST screening is reliable in this setting and well-accepted by patients. Patient-led screening in the cancer care ambulatory setting has potential to improve patient autonomy in their care and screening completion rates.