Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002-Re analysis based on a prospective cohort study / 中华临床营养杂志

The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).

Evidências de validade da escala de avaliação de ansiedade em adolescentes brasileiros / Evidence of validity of the assessment scale for anxiety in Brazilian adolescents / Evidencias de validez de la escala de evaluación de ansiedad en adolescentes brasileño

A ansiedade apresenta indicadores relacionados com marcadores somáticos, motores e cognitivos. Embora o interesse na investigação da regulação da ansiedade seja evidente entre pesquisadores, a oferta de instrumentos validados ainda é restrita. O objetivo deste artigo é apresentar o estudo de validade de critério da escala de avaliação de ansiedade em adolescentes. Houve a seleção de dois grupos-critério: um grupo clínico de 62 adolescentes com diagnóstico psiquiátrico (Transtorno de Ansiedade Generalizada, Fobia Social, Fobia Específica ou Transtorno de Pânico) e outro de 23 adolescentes escolares indicados pelos professores por apresentarem comportamentos relacionados à ansiedade. Análises de follow up revelaram que todos os grupos comparados tiveram diferenças. O grupo II apresentou mais indicativos de desajustamento psicológico (ansiedade) do que a amostra comunitária e menos do que a amostra clínica. Os resultados demonstram evidências de validade de critério da Escala de Avaliação de Ansiedade para Adolescentes por grupos critérios.

Anxiety presents indicators related to somatic, motor and cognitive markers. Although interest in the investigation of regulation of anxiety is evident among researchers, the supply of validated instruments is still restricted. The purpose of this paper is to present the study to determine criterion validity of the scale for evaluation of anxiety in adolescents. Two criterion-groups were selected: a clinical group of 62 adolescents with psychiatric diagnosis (Generalized Anxiety Disorder, Social Phobia, Specific Phobia or Panic Disorder) and a group of 23 teenage students indicated by teachers forhaving anxiety related behaviors. Follow up analyzes revealed that all comparison groups presented differences. Group II presents more indicative of psychological problems (anxiety) than the community sample and less than the clinical sample. The results show evidence of criterion validity of the Anxiety Evaluation Scale for Adolescents based on comparing scores on criterion groups.

La ansiedad presenta indicadores relacionados con marcadores somáticos, motores y cognitivos. Si bien el interés en la investigación de la regulación de la ansiedad sea evidente entre investigadores, el suministro de instrumentos validados es aún limitado. El objetivo de este artículo es presentar el estudio de validez de criterio de la escala de evaluación de ansiedad en adolescentes. Se sucedió a la selección de dos grupos-criterio: un grupo clínico de 62 adolescentes con diagnóstico psiquiátrico (Trastorno de Ansiedad Generalizada, Fobia Social, Fobia Específica o Trastorno de Pánico) y otro de 23 adolescentes escolares indicados por profesores por presentaren comportamientos relacionados a la ansiedad. Análisis de follow up revelaron que todos grupos comparados tuvieron diferencias. El grupo II presento más indicativos de desajuste psicológico (ansiedad) que la muestra comunitaria y menos que la muestra clínica. Los resultados demostraron evidencias de validez de criterio para la Escala de Evaluación de Ansiedad para Adolescentes por grupos criterios.

Validade clínica / Clinical validity

Desenvolvemos o conceito de validade clínica, contextualizando as limitações de validade dos instrumentos e procedimentos de avaliação psicológica. Argumentamos que a validade de um indicador na abordagem nomotética é estabelecida no processo de atribuição de significados a ele, que são derivados de sua associação com as teorias e outros indicadores. Este processo de atribuição de significados é fundamentalmente qualitativo, semelhante ao processo de construção teórica. Demonstramos como a validade não é uma propriedade dos instrumentos ou procedimentos, mas do processo de associações qualitativas inferidas com base em relações observadas. Conceituamos a validade clínica mostrando a necessidade de buscar formas de estimar a validade das informações para cada sujeito singular. Apresentamos então critérios para validade clínica, fundamentando-os na articulação das informações que tomam o sujeito, seu contexto e sua história pessoal como parâmetros.

This paper presents the concept of clinical validity in the context of the limitations in the validity of psychological assessment instruments and procedures. It argues that the validity of an indicator in the nomothetic approach is established in the process of attributing meanings to it, derived from its association with related indicators and theories. This process of attributing meanings is fundamentally qualitative, similar to the process of theoretical construction. It demonstrates that validity is not a property of instruments or procedures, but of the process of qualitative associations inferred from observed relationships. It presents a concept for clinical validity showing the need to search for ways to estimate the validity of information for each subject. The criteria for clinical validity are presented, based on the articulation of information that takes the subject and his or her personal context and history as reference.

Clinical Validity of the Domestic EEG and Mapping System(Neuronics) / 수면정신생리

The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerzied EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.