Origins of the Malnutrition Screening Tool (MST)
In 1999, the Malnutrition Screening Tool (MST) was developed by a team of researchers led by M. Ferguson, with key contributions from S. Capra, J. Bauer, and M. Banks. The goal was to create a valid and reliable screening instrument specifically for adult acute hospital patients. Their work, which culminated in the MST, focused on creating a simple yet effective tool that could be easily administered by various healthcare staff to identify patients at risk of malnutrition. Published in the journal Nutrition, their study laid the groundwork for this widely adopted tool.
The Need for a Simple Screening Tool
Before the MST's development, nutritional screening often relied on more complex methods, such as the Subjective Global Assessment (SGA), which required more time and specialized clinical knowledge. There was a recognized need for a practical, user-friendly tool that could be quickly integrated into routine hospital admissions. A straightforward and accessible screening method allows for the early detection of malnutrition, enabling timely intervention and potentially improving patient outcomes.
How the Malnutrition Screening Tool Works
The MST is known for its simplicity, featuring just two core questions that can be completed in a few minutes. This efficiency is a key reason for its widespread use in acute care settings. The tool assesses risk based on two primary factors:
- Unintentional weight loss: The patient is asked if they have lost weight recently without trying. If they have, the amount of weight lost is scored accordingly.
- Poor appetite/decreased intake: The second question asks if the patient has been eating poorly due to a decreased appetite.
A total score is calculated, with a score of two or more indicating that the patient is at risk of malnutrition and requires a more comprehensive nutritional assessment.
Benefits of the Malnutrition Screening Tool
The MST offers several advantages in a clinical environment:
- Speed and ease of use: The tool's simple, two-question format makes it fast and easy for any trained healthcare professional to complete, even for non-nutrition specialists.
- High reliability and validity: Multiple studies have validated the MST's effectiveness in identifying at-risk patients, making it a trusted tool.
- Predictive ability: It has been shown to be effective in predicting nutritional risk, correlating well with more detailed nutritional assessments.
- Wide applicability: While originally for adult acute care, it has been validated for use across various settings, including outpatient clinics and residential aged care.
Comparison of Major Nutritional Screening Tools
While the MST is a popular choice, several other validated screening tools exist, each with its own focus and application. A comparison highlights their key differences:
| Feature | MST | MUST | MNA-SF | NRS-2002 |
|---|---|---|---|---|
| Developer | Ferguson et al. (1999) | BAPEN (2003) | Rubenstein et al. (2001) | Kondrup et al. (2002) |
| Target Population | Adults in acute hospital settings | All adults in various settings | Elderly patients (>65 years) | Hospitalized adults, ESPEN-recommended |
| Number of Questions | 2 | 5 steps (incorporates multiple factors) | 6 (screening part) | Initial 4, followed by final screening |
| Key Components | Weight loss & appetite | BMI, weight loss, acute disease effect | Intake, weight loss, mobility, illness, BMI | BMI, weight loss, food intake, disease severity, age |
| Ease of Use | Very quick and simple | Slightly more complex, requires calculations | Moderate, more detail than MST | More complex, requires clinical judgment |
For more in-depth information on the Malnutrition Universal Screening Tool (MUST), you can refer to the official guidelines published by BAPEN.
Evolving Standards in Malnutrition Care
Since the MST's introduction, the field of nutritional care has continued to advance. The Global Leadership Initiative on Malnutrition (GLIM) criteria, for example, represents a global consensus on diagnosing malnutrition, involving a two-step process of screening followed by assessment. While the MST remains a valuable and highly-regarded screening tool (Grade I evidence according to the Evidence Analysis Library), the overall approach to malnutrition is now more standardized and comprehensive. The MST continues to play a vital role in the initial screening phase, flagging individuals who require more detailed investigation under these broader frameworks.
Conclusion
The Malnutrition Screening Tool (MST) was developed by a team of Australian researchers, including M. Ferguson, S. Capra, J. Bauer, and M. Banks, in 1999. Created to simplify the process of identifying malnutrition risk, the MST utilizes two simple questions about weight loss and appetite. Its development marked a significant step in standardizing nutritional screening in adult acute hospital settings. While other effective tools like MUST and MNA-SF exist for different contexts, the MST's ease of use and reliability have ensured its continued relevance. Its foundational contribution to nutritional screening continues to support better patient outcomes by enabling the early identification and management of malnutrition risk across various healthcare environments.
