| 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 |
| OtherDetails Language Independent | {licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, 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, current_contact=Alan D. March, Alan D. March |
| Keywords | MUST, malnutrition, undernutrition, obesity, nutrition, nourishment |
| Lifecycle | in_development |
| UID | 7aa7f578-0b71-4313-8322-eca9ada2c8c7 |
| Language used | en |
| Citeable Identifier | 1013.1.2805 |
| Revision Number | 0.0.1-alpha |
| All | Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Screening tool for malnourishment, undernutrition or obesity., archetypeConceptComment=null, otherContributors=, originalLanguage=en, translators= , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={source=[], identities=[], contacts=[], ism_transition=[], provider=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0020]/items[at0021], code=at0021, itemType=ELEMENT, level=2, text=Height determination method for body mass index, description=Method used for determining height as a part of body mass index calculation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
All not explicitly excluded archetypes, extendedValues=null]], description=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=POINT_EVENT, level=2, text=Any event, description=Default, unspecified point in time event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=null, extendedValues=null]], details=[], context=[], target=[], capabilities=[], items=[], other_participations=[], content=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0040]/items[at0038], code=at0038, itemType=ELEMENT, level=4, text=Confounding factors, description=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., comment=Examples of confunding factors are fluid disturbances, lactation, pregnancy, critical illness and amputations. These and other situations deemed as confunding should be registered here., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], activities=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Body mass index score, description=Derived from the subject’s body mass index., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: >20 (>30 Obese) [*] 1: 18.5 -20 [*] 2: <18.5 [*] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=Weight loss score, description=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)., comment=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., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: <5 % [*] 1: 5-10 % [*] 2: >10 % [*] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0012], code=at0012, itemType=ELEMENT, level=4, text=Acute disease effect score, description=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., comment=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., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=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.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0015], code=at0015, itemType=ELEMENT, level=4, text=Total score, description=The sum of scores for body mass index, weight loss and acute disease effect., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=[SNOMED-CT: , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=4, text=Risk category, description=The overall risk of malnutrition as derived from the total score., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null] |