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University of Groningen Assessment of malnutrition in patients with head and neck cancer: a multidimensional approach Sealy, Martine Jane

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(1)University of Groningen. Assessment of malnutrition in patients with head and neck cancer: a multidimensional approach Sealy, Martine Jane. IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below.. Document Version Publisher's PDF, also known as Version of record. Publication date: 2019 Link to publication in University of Groningen/UMCG research database. Citation for published version (APA): Sealy, M. J. (2019). Assessment of malnutrition in patients with head and neck cancer: a multidimensional approach.. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum.. Download date: 27-06-2021.

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(6) Assessment of malnutrition in patients with head and neck cancer: a multidimensional approach. Proefschrift. ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen op gezag van de rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op woensdag 10 april 2019 om 14.30 uur. door. Martine Jane Sealy geboren op 21 januari 1972 te Sneek .

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(191) 7KHKLJKHUWKH6&9,WKHPRUHFRQVHQVXVRQWKHQDWXUHRIWKHFRQVWUXFWFDQEH DVVXPHG ,Q WKLV V\VWHPDWLF UHYLHZ DQ DGHTXDWH OHYHO RI FRQVHQVXV ZDV ZDUUDQWHG E\ UHO\LQJ RQ WZR GHfiQLWLRQV WKDW ZHUH EDVHG RQ EURDG H[SHUW FRQVHQVXV :H IRFXVHG RQ DVVHVVLQJ WR ZKDW H[WHQW WKLV PXOWLGLPHQVLRQDO FRQVHQVXV FRQVWUXFW ZDV DGHTXDWHO\ UHIOHFWHGLQPHWKRGVWKDWRSHUDWLRQDOL]HLW7KHUHIRUHWKH&9,DSSURDFKZDVDGDSWHGIRU WKLV VWXG\ DV IROORZV HYHU\ DVVHVVPHQW PHWKRG ZDV FRPSDUHG WR WKH IL[HG VHW RI NH\ FRQFHSWVZLWKLQWKHGRPDLQVDVGHVFULEHGDERYH 7DEOH

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(193) LQVWHDGRI,&9,ZDVFDOFXODWHGSHUGRPDLQE\GLYLGLQJWKHQXPEHURINH\FRQFHSWV ZLWKLQ WKH GRPDLQ FRQVLGHUHG SUHVHQW E\ WKH WRWDO QXPEHU RI NH\ FRQFHSWV ZLWKLQ WKH GRPDLQ)RULQVWDQFHLILQDPHWKRGWZRRXWRIIRXUNH\FRQFHSWVDUHSUHVHQWLQGRPDLQ% WKH'&9,IRUGRPDLQ% '&9,%

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(197)  )RU6&9,DFXWRIIYDOXH of ≥ 0.80 has been reported as acceptable. 7KLV WKUHVKROG IRU DFFHSWDEOH FRQWHQW FRYHUDJHRILVEDVHGRQWKHDVVXPSWLRQWKDWWKHPLQLPXPFRYHUDJHRI,&9,WKHVFRUH ZHDGDSWHGWR'&9,VKRXOGEHDURXQGLQRUGHUWRVDIHJXDUGJRRGFRYHUDJHRILWHPV RUGRPDLQV,QRXUVWXG\ZHDOVRFRQVLGHUHGDQ0CVI value ≥0.80 acceptable. $OWKRXJK0&9,VFRUHUDQJHVIURPWRLWFDQEHFRQVLGHUHGDQRPLQDONH\FRQFHSWVFRUH WUDQVIRUPHGWRDZHLJKWHGDYHUDJHVFRUH)RUWKLVUHDVRQPHGLDQ&9,VFRUHVZHUHUHSRUWHG DQG QRQSDUDPHWULF VWDWLVWLFDO PHWhods were applied. Kendall’s tau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

(198) WR WKH SULPDU\ VFHQDULR 6LPLODU WR WKH SULPDU\ VFHQDULR PHWKRGLWHPV ZHUH VFRUHG HLWKHU ‘present’ or ‘not present’ for each key concept and scores were weighted per GRPDLQ 6XPPDUL]HGFRQWHQWYDOLGLW\VFRUHVIRUWKHIRXUGRPDLQV 0&9,$'

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(200) Limited content validity across methods of malnutrition assessment. RXWFRPHDVHFRQGVHQVLWLYLW\DQDO\VLVZDVSHUIRUPHGE\FRPELQLQJNH\FRQFHSWVWKDWFRXOG be interpreted as overlapping. Therefore, in this analysis the key concept ‘deficiency or imbalance of overall nutrition’ was combined with ‘deficiency or imbalance of energy intake’, and ‘subjective assessment of adverse effects on body composition’ was combined with ‘objective assessment of adverse effects on body composition’. In this way, an DOWHUQDWLYH VHW RI QLQH NH\ FRQFHSWV ZLWKLQ GRPDLQ $& ZDV FRQVWUXFWHG ZLWK WKUHH NH\ FRQFHSWVLQHDFKGRPDLQ$JDLQPHWKRGitems were scored either ‘present’ or ‘not present’ IRUHDFKNH\FRQFHSWDQGVFRUHVZHUHZHLJKWHGSHUGRPDLQ7KHZHLJKWHGVXPPDU\VFRUH FDOFXODWHGSHUPHWKRGIRUWKHVHQLQHNH\FRQFHSWVLVUHIHUUHGWRDV0&9,$&,QWKHWKLUG VHQVLWLYLW\ DQDO\VLV HDFK RI WKH HOHYHQ NH\ FRQFHSWV ZDV JLYHQ HTXDO LPSRUWDQFH :H FDOFXODWHGDQXQZHLJKWHGDYHUDJHVFRUHIRUWKHNH\FRQFHSWVIURPGRPDLQ$WR& $YH$&

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(211)  KDG LWHPV EHORQJLQJ WR GRPDLQ % WKLUWHHQ methods (35%) included domain C, and 23 methods (62%) included domain D. ‘ChanJH in body weight and surface’ was the key concept most frequently present, in 20 (54%) of the methods. The key concept ‘cognitive function’ was represented once (3%) in MNA. 7KH PHWKRGV WKH QXPEHU RI PHWKRGLWHPV SHU GRPDLQ DQG WKH 0&9,$& VFRUHV DUH SUHVHQWHGLQ7DEOHDQGGLVWULEXWLRQRIPHWKRGLWHPVDFURVVNH\FRQFHSWVDQGGRPDLQV LVSUHVHQWHGLQ2QOLQHVXSSOHPHQW V7KHPHGLDQWRWDORISUHVHQWNH\FRQFHSWVSHUPHWKRG ZDVRXWRI ,QWHUTXDUWLOH5DQJH>,45@

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