Original Title: Herramientas de detección y seguimiento ambulatorio de desnutrición en pacientes oncológicos

Authors' objectives: This report aims to assess the effectiveness, efficiency, and safety of tools for detecting and monitoring outpatient malnutrition in cancer patients, as well as the economic and organizational aspects and patients’ perspectives associated with implementing these tools in an outpatient setting.

Authors' results and conclusions: Results Our systematic review included 35 primary studies in total. Of these, 30 evaluated variables related to diagnostic efficacy. Of the remaining 5 primary studies, two addressed organizational aspects, such as the need for nutrition training for professionals and patients, and the other three explored variables related to the patient’s perspective. Twenty-three tools were identified as index tests and 10 as comparators or reference standards. The tools analysed most frequently in the reviewed studies were MUST, MST, MNA, and PG-SGA (and its abbreviated version). The tools most commonly used as a reference method for concurrent validation were PG-SGA, GLIM and SGA in the selected studies. Conclusions The available evidence on the efficacy and safety of the tools identified in SRs and primary studies suggests that the detected tools may be suitable for identifying and diagnosing malnutrition in cancer patients in an outpatient setting. In general, integrating tools into the routine practice of outpatient clinics for detecting malnutrition and following up cancer patients may be helpful. However, it’s crucial to emphasize the necessity of an individual and continuous evaluation of their efficacy, safety, and cost-effectiveness for their implementation, ensuring ongoing improvement in patient care.

Authors' methods: Methods A systematic review of the literature in two phases. The first phase limited the search to technology evaluation reports, systematic reviews and meta-analyses, followed by a second search to identify primary studies. Specific search strategies were developed, and the following electronic databases were consulted: Medline (Ovid), Embase (Excerpta Medica Database), Cochrane Library (Cochrane Review Database), INAHTA (International HTA Database), WOS (SCI Science Citation Index) and CINAHL (Cumulative Index of Nursing and Allied Literature). On the other hand, resources such as TripDataBase were consulted, as well as the leading websites of international agencies: National Institute for Health and Care Excellence (NICE), Canadian Agency for Drugs and Technologies in Health (CADTH), Agency for Healthcare Research and Quality (AHRQ) and the Spanish Network of Health Technology Assessment Agencies and Benefits of the SNS (RedETS). Finally, Clinical Trials Registers, ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) were also consulted. Three independent researchers analysed car quality, and the synthesis of the results was carried out quantitatively. The tools selected to assess the quality of the included studies were AMSTAR-2 for systematic reviews and QUADAS-2 for primary diagnostic studies.

Authors' identified further research: Further research is needed to expand the available evidence and improve its methodological quality. Although evidence has been found at the synthesis level (3 systematic reviews) for the use of malnutrition screening tools in outpatient cancer patients, no significant adverse events (MAs) have been identified. Therefore, randomized controlled trials (RCTs) or observational clinical studies with an appropriate design and sample size are needed to enable future MAs. Furthermore, more research is needed to expand the available evidence with studies that include economic aspects and the patient's perspective for the other tools.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/herramientas-de-deteccion-y-seguimiento-ambulatorio-de-desnutricion-en-pacientes-oncologicos/

Year Published: 2025

URL for published report: https://www.aetsa.org/download/publicaciones/03-Desnutriciu00f3n-en-pacientes-oncolu00f3gicos_web.pdf

Requestor: Spanish Health Ministry

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

DOI: 10.52766/NXNJ5187

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: <p>Andalusian Agency for Health Technology Assessment (AETSA)</p>