Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings
Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings
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DOI：
10.2105/ajph.2017.304033
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发表时间：
2017-11-01
影响因子：
12.7
通讯作者：
Lindau, Stacy Tessler
中科院分区：
文献类型：
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作者：
Makelarski, Jennifer A.;Abramsohn, Emily;Lindau, Stacy Tessler
目标。为检验美国儿科学会(AAP)推荐的食品不安全筛查方法的诊断准确性。我们于2016年7月至11月在伊利诺伊州芝加哥进行了前瞻性诊断准确性研究。我们从成人和儿科急诊科招募了方便的成人样本(12个月回忆研究：188人；30天回忆研究：154人)。一项自我管理的调查包括6项家庭食品安全筛查(黄金标准)、有效的2项饥饿生命体征(HVS；经常，有时，从不回答类别)和2项AAP工具(是或否回答类别)。食品不安全很普遍(12个月召回组：46%；30天组：39%)。使用12个月和30天回忆的AAP工具的敏感性分别为76%(95%可信区间=65%，85%)和72%(95%CI=57%，84%)。HVS的敏感性显著高于AAP工具(12个月：94%[95%CI=86%，98%；P=.002]；30天：92%[95%CI=79%，98%；P=.02])。AAP工具漏掉了在医院接受筛查的近四分之一食物不安全的成年人；HVS筛查工具更敏感。对公共健康的影响。采用粮食不安全筛查的卫生保健系统应优化筛查工具的易管理性和敏感性。
Objectives. To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener.Methods. We conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories).Results. Food insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI] = 65%, 85%) and 72% (95% CI = 57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI = 86%, 98%; P = .002]; 30-day: 92% [95% CI = 79%, 98%; P = .02]).Conclusions. The AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications. Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool.