Assessment

 

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Position statement recommendations


All people with cancer identified as being 'at risk' of malnutrition following appropriate screening or with a cancer diagnosis or treatment plan known to lead to high risk of malnutrition should have comprehensive nutrition assessment using a tool validated in the oncology population.

 


All people with cancer identified as being 'at risk' of sarcopenia following appropriate screening should have a comprehensive evaluation of muscle status using a combination of assessments for muscle mass, muscle strength and function.

 


Interpretation of diagnostic criteria for sarcopenia should be applied recognising that:
a. Threshold values for assessing muscle mass, muscle strength and physical performance are variable.
b. Care should be taken to determine the appropriate cut-off values in the population in which they are being applied.
c. Most data regarding muscle strength and performance comes from older populations.
d. The applicability of diagnostic criteria in different ethnicities is uncertain.


Please refer to the position statement for more detail regarding the above recommendations.

The links below are for easy access to resources, but you will need to refer to the assessment section of the Toolkit PDF document for details of who, when, when and how to use them.

Diagnostic Criteria

Malnutrition

Global Leadership initiative on Malnutrition (GLIM)
Patient Generated-Subjective Global Assessment (PG-SGA)
Subjective Global Assessment (SGA)

Sarcopenia

European Working Group on Sarcopenia in Older People (EWGSOP1)
European Working Group on Sarcopenia in Older People updated definition (EWGSOP2)
Foundation for the National Institutes of Health biomarkers consortium sarcopenia project (FNIH)
Cancer specific CT image analysis

How to complete assessment

Provided below are a battery of assessment tools/measures. Please choose the assessment tools/measures appropriate to your local context. Please refer to the assessment section of the Toolkit PDF document for further details on how to do this.

Malnutrition

PG-SGA how to guide
SGA instructional video

Muscle mass

PG-SGA physical exam (see above guides)
Calf-circumference how to guide
Calf-circumference instructional video
Bioelectric impedance analysis how to guide
Bioelectric impedance analysis instructional video 1
Bioelectric impedance analysis instructional video 2
Bioelectric impedence spectroscopy analysis how to guide
Bioelectric spectroscopy analysis instructional video

Muscle strength

Handgrip strength how to guide
Handgrip strength instructional video 1
Handgrip strength instructional video 2
Chair stand test how to guide
Chair stand test instructional video

Muscle Function

Short physical performance battery how to guide
Short physical performance battery instructional video 1
Short physical performance battery instructional - chair stand test
Short physical performance battery instructional - gait speed test
Short physical performance battery instructional - balance test
Timed up & go how to guide
Timed up & go instructional video 1
Timed up & go instructional video 2
Gait speed test how to guide
Gait speed test instructional video
400m walk test how to guide
400m walk test instructional video

Exemplars of evidence-based care in practice

Assessment of skeletal muscle via CT
Nutrition care pathway for upper GI cancer surgery
Prehabilitation for patients undergoing GI surgery
Advocating with the MDT for a business case to establish a new clinical service 
How to train clinicians in new assessment measures

Patient case studies

Case study 3 - oral therapy 
Case study 4 - rural patient