Development, validity and reliability of the Derby Nutritional Score

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The Derby Nutritional Score (DNS) is a new instrument which has been developed to screen the nutritional status of all adult patients on admission to hospital. In this article we describe the rationale for its development and report the findings of two related studies in which the validity and inter-rater reliability of the instrument were evaluated.


Eighty-nine patients were screened by nursing staff on admission using the DNS and were assessed within 8 h by an experienced senior dietitian using a Dietetic Assessment Scale (DAS). In the reliability study, 70 patients were screened by five experienced nurses within 8 h of admission.


Moderately good agreement (kappa = 0.6) was reached between scores obtained using the DNS and ratings obtained by the DAS. Similarly, agreement between pairs of nurses with respect to classification of nutritional risk was found to be high (median kappa = 0.7).


The DNS appears to be a valid and reliable instrument which can be administered accurately and relatively quickly by trained nursing staff to identify patients at risk of malnutrition.

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