Validity and Reliability of a Thai-Translated Malnutrition Screening Tool in an Outpatient Setting: A Comparison with the GLIM Criteria
Abstract
Objective: The malnutrition screening tool (MST) has been widely validated for detecting malnutrition in various countries. However, its applicability in Thai outpatient settings remains unexplored. This study aimed to translate the MST into Thai and assess its validity and reliability compared to the global leadership initiative on malnutrition (GLIM) criteria.
Material and Methods: A cross-sectional study was conducted at a tertiary care hospital, including 248 participants. Nutritional status was evaluated using the Thai-translated MST (T-MST), mini nutritional assessment-short form (MNA-SF), and GLIM criteria, which included bioelectrical impedance analysis for muscle mass assessment. Sensitivity, specificity, area under the receiver operating charateristic curve (ROC-AUC), test-retest reliability, inter-rater reliability, and internal consistency (item-total score correlation and Cronbach’s alpha) were analyzed to assess the MST’s performance relative to the GLIM criteria.
Results: The Thai version of the MST demonstrated excellent test-retest reliability (intraclass correlation coefficient [ICC]=0.976, p-value<0.001) and inter-rater reliability (ICC=0.917, p-value<0.001). It showed strong agreement with the GLIM criteria (Kappa=0.843), comparable to the MNA-SF (Kappa=0.834). Internal consistency was satisfactory (Cronbach’s alpha=0.794). The T-MST achieved a sensitivity of 86.5% and specificity of 96.0%, while the MNA-SF showed a sensitivity of 93.2% and specificity of 93.1% against the GLIM criteria. Both tools demonstrated excellent predictive accuracy (ROC-AUC: T-MST=0.907, MNA-SF=0.929).
Conclusion: The T-MST is a reliable and efficient tool for malnutrition screening in outpatient settings. Its simplicity and ease of use make it particularly valuable in time-constrained environments. However, ongoing validation across diverse populations and settings is essential to ensure consistent performance across different clinical contexts.
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