Global Leadership Initiative on Malnutrition (GLIM): Guidance on Validation of the Operational Criteria for the Diagnosis of Protein‐Energy Malnutrition in Adults
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Background: The Global Leadership Initiative on Malnutrition (GLIM) created a consensus‐based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different healthcare settings. As with other consensus‐based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing, as they are currently based solely on expert opinion. Methods: Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. Results: There are some aspects of GLIM that require refinement; research using large databases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut points and combinations of indicators for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that validation and reliability testing need to occur in a variety of sectors and populations and with diverse persons using GLIM criteria. Conclusion: The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM.
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One meta-analysis included a general sample of 20 studies with 10,781 patients from 13 countries, showing sensitivity of 72% (range 51%-92%) and specificity of 82% (range 73%-98%) relative to SGA or Patient-Generated SGA as the mainly used semi-gold standard.
“One included a general sample (mixed settings) of 20 studies with 10,781 patients from 13 countries, showing a sensitivity of 72% with a range of 51%–92% (ie, capacity to identify true positive cases) and a specificity of 82% with a range of 73%–98% (ie, capacity to identify true negative cases) relative to SGA or Patient‐Generated SGA as the mainly used semi‐gold standard.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [7]
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Experimental — accuracy not yet measuredThe GLIM Consortium provided a guidance paper on how to perform studies targeting construct or criterion validity and predictive validity.
“the GLIM Consortium provided a guidance paper 7 , 8 on how to perform studies targeting construct or criterion validity (ie, to assure that the model identifies malnutrition) and predictive validity (ie, that the model identifies cases with adverse clinical outcomes).”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [7]
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- Authors
- Keller, H., de van der Schueren, M. A. E., for the GLIM Consortium, Jensen, G. L., Barazzoni, R., Compher, C., Correia, M. I. T. D., Gonzalez, M. C., Jager‐Wittenaar, H., Pirlich, M., Steiber, A., Waitzberg, D., & Cederholm, T.
- Affiliations
- University of Waterloo (CA)
- Department of Nutrition and Health School of Allied Health HAN University of Applied Sciences Nijmegen the Netherlands
- University of Vermont (US)
- University of Trieste (IT)
- University of Pennsylvania (US)
- Universidade Federal de Minas Gerais (BR)
- Post‐Graduate Program in Health and Behaviour Catholic University of Pelotas Pelotas Rio Grande do Sul Brazil
- University Medical Center Groningen (NL)
- Endocrinology, Gastroenterology, Clinical Nutrition Imperial Oak Outpatient Clinic (Kaisereiche) Berlin Germany
- Academy of Nutrition and Dietetics (US)
- Universidade de São Paulo (BR)
- Uppsala University (SE)
- Corresponding author
- Keller, Heather
- ORCID
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2020-06-11
- Volume
- 44
- Issue
- 6
- Pages
- 992-1003
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W3034377458
- Cited by
- 131
- References
- 44
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 29 · 2023: 21 · 2022: 23 · 2021: 30 · 2020: 5
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- GLIM, protein-energy malnutrition, criterion validity, construct validity, reliability testing, machine learning, cut points
- MeSH terms
- Adult, Humans, Leadership, Nutritional Status, Prospective Studies, Protein-Energy Malnutrition, Retrospective Studies, Reproducibility of Results, Malnutrition
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