| ARCHETYPE ID | openEHR-EHR-OBSERVATION.must.v0 |
|---|---|
| Concept | Malnutrition Universal Screening Tool (MUST) |
| Description | Screening tool for malnourishment, undernutrition or obesity. |
| Use | MUST is a five-step screening tool: Step 1.- Measure height and weight to get a BMI score. If unable to obtain height and weight, the alternative procedures shown in the MUST Explanatory Booklet should be used. Step 2.- Note percentage unplanned weight loss and score using tool specific tables. Step 3.- Establish acute disease effect and score. Step 4.- Add scores from steps 1, 2 and 3 together to obtain overall risk of malnutrition. Step 5.- Use management guidelines and/or local policy to develop care plan. This archetype registers data for calculation of the overall risk of malnutrition score. |
| Misuse | Not to be used for children. |
| Purpose | The Malnutrition Universal Screening Tool (MUST) is a scoring system designed to help identify adults who are malnourished, at risk of malnutrition (undernutrition), or obese. It intends to identify risk of poor protein-energy status, rather than status of individual nutrients. It has not been designed to detect deficiencies in or excessive intakes of vitamins and minerals. It was developed and is maintained by the British Association for Parenteral and Enteral Nutrition (BAPEN). |
| References | Elia, Marinos (2003): Screening for malnutrition: a multidisciplinary responsibility. Development and use of the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for adults. Malnutrition Advisory Group, a Standing Committee of BAPEN. Redditch: BAPEN (ISBN 1899467 70 X). Stratton, RJ, Hackston, A, Longmore, D, et al. (2004): Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr 92, 799–808. http://tinyurl.com/jj8grzo Todorovic, Vera, Russell, Christine, Elia, Marinos (2011): The ‘MUST’explanatory booklet: A Guide to the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for adults. Redditch: BAPEN (ISBN 978-1-899467-71-6). http://tinyurl.com/7vrjsyb |
| Copyright | © openEHR Foundation |
| Authors | Author name: Alan D. March Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina Email: alandmarch@gmail.com Date originally authored: 2016-06-12 |
| Other Details Language | Author name: Alan D. March Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina Email: alandmarch@gmail.com Date originally authored: 2016-06-12 |
| Other Details (Language Independent) |
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| Keywords | MUST, malnutrition, undernutrition, obesity, nutrition, nourishment |
| Lifecycle | in_development |
| UID | 7aa7f578-0b71-4313-8322-eca9ada2c8c7 |
| Language used | en |
| Citeable Identifier | 1246.145.2527 |
| Revision Number | 0.0.1-alpha |
| protocol | |
| Height determination method for body mass index | Height determination method for body mass index: Method used for determining height as a part of body mass index calculation.
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| Weight determination method for body mass index | Weight determination method for body mass index: Method used for determining weight as a part of body mass index calculation.
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| Body mass index estimation method | Body mass index estimation method: Method used for determining body mass index.
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| Weight loss determination method | Weight loss determination method: Method used for determining weight change.
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| Extension | Extension: Additional information required to capture local context or to align with other reference models/formalisms. For example: Local hospital departmental infomation or additional metadata to align with FHIR or CIMI equivalents. Include: All not explicitly excluded archetypes |
| state | |
| Confounding factors | Confounding factors: Some variables used in the calculation of the MUST score may be influenced by confunding factors, specially in the case of weight and BMI determination. Examples of confunding factors are fluid disturbances, lactation, pregnancy, critical illness and amputations. These and other situations deemed as confunding should be registered here. |
| data | |
| Body mass index score | Body mass index score: Derived from the subject’s body mass index. 0: >20 (>30 Obese) [*] 1: 18.5 -20 [*] 2: <18.5 [*] |
| Weight loss score | Weight loss score: To establish the subject’s weight loss score, ask if there has been any weight loss in the last 3 – 6 months, and if so how much (or look in their medical records). Deduct current weight from previous weight to calculate amount of weight lost and calculate percentage. If the subject has not lost weight (or has gained weight) score 0. 0: <5 % [*] 1: 5-10 % [*] 2: >10 % [*] |
| Acute disease effect score | Acute disease effect score: If the subject is currently affected by an acute patho-physiological or psychological condition, and there has been no nutritional intake or likelihood of no intake for more than 5 days, they are likely to be at nutritional risk. Such patients include those who are critically ill, those who have swallowing difficulties (e.g. after stroke), or head injuries or are undergoing gastrointestinal surgery. 0: Not acutely ill and sufficient nutritional intake for >5 days [If patient is not acutely ill and there has not been or is not likely to be no nutritional intake for >5 days.] 2: Acutely ill and there has been or is likely to be no nutritional intake for >5 days [If patient is acutely ill and there has been or is likely to be no nutritional intake for >5 days.] |
| Total score | Total score: The sum of scores for body mass index, weight loss and acute disease effect. min: >=0; max: <=6 |
| Risk category | Risk category: The overall risk of malnutrition as derived from the total score.
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| Comment | Comment: Additional narrative about the screening, not captured in other fields. |
| events | |
| Any event | Any event: Default, unspecified point in time event which may be explicitly defined in a template or at run-time. |
| Other contributors | |
| Translators |