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Research project: Predicting weight loss in people with cancer: Development and validation of a screening tool - Dormant - Dormant

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The cachexia anorexia syndrome is associated with increased morbidity and mortality in people with cancer. The aim of this project is to identify people with cancer who are at greatest risk of future weight loss by the development and validation of a simple and practical screening tool.


The study will assess the performance, individually and in combination of the following measures:


  • the Appetite and Symptom Questionnaire (ASQ);
  • the Malnutrition Universal Screening Tool (MUST);
  • C-Reactive Protein (CRP) level;

In predicting percentage weight loss over three months. By identifying the best combination of these measures a validated simple and practical screening tool will be developed to identify patients who are at risk of future weight loss. This will allow nutritional treatment to be prioritised and commenced where needed before the downward spiral of cachexia and malnutrition begins.


Phase I: Test-retest analysis will be performed to determine the reliability of a new 12 item ASQ which assesses appetite, associated symptoms and dietary intake. Radiotherapy patients (n=25 approx.) whose weight is stable will be asked to complete the ASQ on two occasions, one week apart.

Phase II: Using a longitudinal observational study design with two test-points, patients (n=200 approx.) with a confirmed diagnosis of cancer will be recruited from out-patient lung and upper GI oncology clinics at Nottingham University Hospitals.

Expected outcomes

  1. An estimate of the reliability of the ASQ (phase I).
  2. A screening tool based on the ability of the optimal combination of items from the three measures (ASQ, MUST, CRP) to predict clinically significant weight loss over three months (phase II).
  3. Estimates of the sensitivity and specificity at various cut-points of the developed screening tool in predicting = 5% three month weight loss and = 10% weight loss (phase II).  

Project team

Julia Addington-Hall, Jane Hopkinson

Project funder

Funded by NCRI Supportive and Palliative Care Capacity Building Grant (grant held at Nottingham University)  2009

Related research groups

Complex Healthcare Processes
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