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.
6. 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.
8. 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.
9. Mesbah S, et al. The self evaluation of food intake SEFI® is feasible and diagnoses malnutrition in the older people living in a nursing home. Clin Nutr 2018;37 (Suppl1): S6.
10. 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.
11. 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.
12. Bouette G, et al. The self evaluation of food intake SEFI® as a tool for malnutrition screening in the community setting: prospective non interventional multicentric study. JFN congress 2018, article in preparation.