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Interpret the results

The interpretation of the results of the SEFI® is based on the results of five clinical studies.


  • In 114 in- and out- adult patients either malnourished or at risk of malnutrition, a strong correlation was found between the score of the visual analogue scale and the daily energy intakes assessed by the 3-day dietary record. (8) Moreover, 81% of those with scores <7 were at risk of malnutrition according to the Nutritional Risk Index (NRI). (10) These results were confirmed by an independent study conducted in 1762 medical oncology patients. (11)

SEFI® allows identifying the risk of malnutrition if visual analogue scale score <7.


  • The European multicenter survey Nutrition Day in 16,290 (6) then 103,920 adult hospitalized patients worldwide established that food consumption ≤50% of offered portions at lunch or dinner was associated with an increased risk (by a factor of 2 to 8) of death 30 days after the evaluation.


SEFI® allows the detection of the risk of malnutrition if the consumed portion is ≤1/2 of the meal main course.


  • In 128 older people living in nursing home, the sensitivity, specificity, positive and negative predictive values of consumed portions ≤50% (evaluated by an health caregiver) to diagnose malnutrition, defined as Mini Nutritional Assessment (MNA)® <17 were respectively: 75, 87, 67, and 91% (AUC=0.81). (9)


In nursing homes, SEFI® diagnoses malnutrition if the consumed portion is ≤1/2 of the meal main course.


  • In 505 patients consulting their GP in the community setting, the sensitivity, specificity, positive and negative predictive values of SEFI® visual analogue scale <7 to diagnose malnutrition defined as weight loss ≥10% in 6 month and/or ≥5% in 1 month and/or BMI ≤18.5 (or <21 if age ≥70 yr), were respectively: 34, 85, 13, and 96%. (12)


In the community setting, SEFI® is accurate to rule out the diagnosis of malnutrition, if score ≥7.

1. Hiesmayr M, et al. Decreased food intake is a risk factor for mortality in hospitalised patients: The Nutrition Day survey 2006. Clin Nutr 2009;28:484-491.

3. Thibault R, et al. Use of 10-point analogue scales to estimate dietary intake: A prospective study in patients nutritionally at-risk. Clin Nutr 2009;28:134-140.

4. Guerdoux-Ninot et al. Assessing dietary intake in accordance with guidelines: Useful correlations with an ingesta- Verbal/Visual Analogue Scale in medical oncology patients. Clin Nutr 2018, Jun 30. pii: S0261-5614(18)31193-2. doi: 10.1016/j.clnu.2018.06.974.

5. Bouëtté G, et al. A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study. Clin Nutr 2021;40:174-180.

7. Mesbah S, et al. The evaluation of consumed food portions as a screening test for malnutrition in the older people living in a nursing home: A cross-sectional pilot study. Nutrition Clin Metab 2023;37:62–67.

8. Billeret A, et al. Assessment of food intake assisted by photography in older people living in a nursing home: maintenance over time and performance for diagnosis of malnutrition. Nutrients 2023;15(3):646.

10. Jouneau S, et al. Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients. Clin Nutr 2022;41:1335-1342.

11. Rageul E et al. Une prise alimentaire insuffisante à l’hôpital est associée à un risque plus élevé de réadmission hospitalière chez des patients pris en charge par l’Unité Transversale de Nutrition (UTN) d’un centre hospitalier universitaire (CHU). Communication orale. Journées Francophones de Nutrition 2022.

12. Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community. Clin Nutr 2019;38:1-9

13. Delarue J, et al. Diagnosing undernutrition children and adults: new French criteria. Why, for what and for whom? A joint statement of the French National Authority for Health and French Federation of Nutrition. Br J Nutr 2022;127:739-751.

18. Buzby GP, et al. A randomised clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr 1988;47 (Suppl. 2):357-365.

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