Dutch Patient-Generated Subjective Global Assessment (PG-SGA): training improves scores for comprehensibility and difficulty

Rationale: The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess and monitor malnutrition, which consists of both patient-reported and professional-reported items. A professional should be able to correctly interpret all items. Untrained professionals may experience difficulty in completing some items of the PG-SGA. We aimed to explore the change in perceived comprehensibility and difficulty of the Dutch PG-SGA by health care professionals on the use of the instrument, before and after training.
Methods: A sample of 36 untrained health care professionals, of which 34 dietitians, completed a set of 29 items on a four point scale regarding comprehensibility and difficulty of the PG-SGA on two separate occasions:
T0) two weeks before and T1) directly after an instructional session on the PG-SGA and training with the physical exam. Summarized comprehensibility indexes (SCI) and difficulty indexes (SDI) were calculated for the patient part of the PG-SGA (aka PG-SGA Short Form; PG-SGA SF), the professional part of the PG-SGA (PG-SGApro) and the full PG-SGA, to quantify the level of perceived comprehensibility and difficulty. SCI≥0.80 and SDI≥0.80 were considered acceptable, SCI≥0.90 and SDI≥0.90 were considered excellent.
Results: SCI of the PG-SGA SF was acceptable both before (SCI: 0.80) and after training (SCI: 0.89). SCI of the PG-SGApro and full PG-SGA changed from unacceptable (SCI: 0.64; 0.69) to excellent (SCI: 0.95; 0.94).
All SDIs changed from unacceptable (SDI for respectively PG-SGA SF, PG-SGApro and full PG-SGA: 0.71; 0.50; 0.57) to acceptable (SDI: 0.88; 0.85; 0.87).
Conclusion: Training professionals in the use of the PG-SGA can be an effective strategy for improving the level of both comprehensibility and difficulty.