Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) among hospital inpatients

  • Albert Westergren
  • Erika Norberg
  • Christina Vallén
  • Peter Hagell
Keywords: MEOF, MNA MEONF, ROC-curve


Background and objective: The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria. Design: Cross-sectional study. Methods: The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs of UN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1). Results: According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%. Conclusions: The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

Keywords: cut-off scores; MEOF; MNA; MEONF; nutritional screening; ROC-curve

(Published: 29 July 2011)

Citation: Food & Nutrition Research 2011. 55 7289 - DOI: 10.3402/fnr.v55i0.7289


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Westergren A., Norberg E., Vallén C., & Hagell P. (2011). Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) among hospital inpatients. Food & Nutrition Research. Retrieved from
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