Diagnostic Performance of SGA, PG-SGA and MUST for Malnutrition Assessment in Adult Cancer Patients: A Systematic Literature Review and Hierarchical Bayesian Meta-Analysis

Abstract

Because cancer-associated malnutrition is a major health complication, timely nutritional screening is of utmost importance. The aim of this study was to conduct a systematic literature review and meta-analysis of three tools in order to identify the method with the best diagnostic performance. PubMed, EMBASE and Cochrane central register of controlled trials were searched for articles published from database inception to January 2021. Studies that assessed the diagnostic accuracy of the SGA, PG-SGA or MUST in adult cancer patients were included. In order to evaluate the quality of each included study, the QUADAS-2 tool was used after which a meta-analysis was conducted using the hierarchical bivariate model. This model accounts for both within and between study variability. 16 studies (18 datasets) were included to evaluate these tools. The overall sensitivity and specificity for SGA was 0.69 and 0.80, 0.95 and 0.81 for PG-SGA, along with 0.83 and 0.83 for MUST respectively. An assessment of the likelihood ratios showed that PG-SGA had the highest LR + and the lowest LR−, it therefore has the best diagnostic performance to confirm malnutrition in adult cancer patients.

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author’s Contributions

Fen Liu designed research; Rena Nakyeyune and Xiaoli Ruan collected, screened and analyzed the data; Rena Nakyeyune drafted the manuscript; Yi Shen, Yi Shao, Chen Niu and Zhaoping Zang provided guidance and support; Fen Liu revised and made the decision to submit for publication. All authors contributed to manuscript revision and approval of the submitted version. This manuscript has not been published and neither has it been submitted simultaneously for publication elsewhere.

Disclsoure Statement

The authors declare that there is no conflict of interest. No grant was received from any funding agency in the public, commercial, or nonprofit sectors for this study.