Validation of the NUTRISCORE nutritional screening tool among cancer patients in selected referral hospitals, Addis Ababa, Ethiopia, 2025GC: A facility-based cross-sectional study
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Date
2025-07
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Addis Ababa University
Abstract
Background: Malnutrition is a common and critical issue in cancer patients, significantly affecting treatment outcomes and overall survival. Timely and accurate identification of malnutrition risk is essential for early intervention. Various nutritional screening tools exist, but many are either time-consuming, lack sensitivity, or are not tailored for outpatient cancer settings. The NUTRISCORE tool has been developed as a fast, accurate, and easy-to-use nutritional screening tool specifically designed for cancer patients. However, there is a need to validate this tool in different populations, as nutritional risk factors can vary by region, healthcare settings, and the demographic profiles of patients. In Ethiopia, where malnutrition and cancer treatment challenges are prevalent, a locally validated tool is crucial for the early detection and management of malnutrition in cancer patients.
Objective: This study aims to assess the validity of the nutritional risk screening tool NUTRISCORE against Full Nutritional Assessment (FNA) among adult cancer patients attending oncology outpatient departments for treatment in Tikur Anbessa Specialized Hospital and St. Paul’s Millennium Medical College in Addis Ababa, Ethiopia.
Methods: A facility-based, cross-sectional study was conducted in the oncology department of TASH and SPMMC. The NUTRISCORE scale was validated against Full Nutrition Assessment (FNA). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Reliability was measured using Cronbach’s alpha. A total of 155 participants were selected through systematic random sampling. Data were collected via patient and caregiver interviews, physical examinations, and laboratory investigations using structured interview questionnaires. Data were collected using Kobo toolbox an electronic data collection and management tool, cleaned and edited accordingly and then exported to IBM SPSS statistical software for analysis.
Result: A total of 155 patients aged ≥18 years participated in this study and 67.1% were female. The sensitivity, specificity, Positive predictive value, Negative predictive value and Area under curve (AUC) of NUTRISCORE against FNA were 36.8%, 88%, 62.5%,71.5% and 0.770 respectively. The internal consistency of NUTRISCORE scale measured using Cronbach’s α coefficient gave a value of α =0.739, indicating acceptable internal consistency.
Conclusion: In this study, NUTRICSCORE showed low level of sensitivity with an acceptable specificity. Thus further research is needed with a larger sample set to assess the validity (performance) of the NUTRISCORE screening tool.
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Keywords
Cancer patients, Malnutrition, NUTRISCORE, FNA