The screening tool should be simple, quick to use, valid, reliable and acceptable to both patient and the nurse. It should be convenient for use in all types of settings and for all types of patients. MUST was developed in Britain with these aims (Gibney et al, 2005). It was developed by the Malnutrition Advisory group, a multidisciplinary group of British Association for parenteral and Enteral Nutrition (BAPEN, 2008), in 2000. It is recommended by British dietetic Association, The Royal College of Nursing, The registered nursing homes Association and The Royal college of Physician (England). It is an evidence based tool designed to detect malnutrition and obesity but not vitamin and mineral deficiency. MUST is developed for use in all adults including elderly, sick or healthy , hospital wards, outpatient clinics, general practice , community settings and public health (Thomas et al, 2007. Morrison et al 2007). A number of studies were conducted in these settings. Agreement was >.95% in all studies prior to recommending the tool in practice, according to BAPEN (2008)
MUST meets all the key requirements of a good tool. The tool is developed by experts in the field and validated by subsequent research. It is easy, quick and reliable besides recommended by recognized professional bodies. The tool has incorporated three elements viz. BMI, unintentional weight loss and acute disease effect to minimise error occurring from single element measurement. The present article is intends to discuss reliability and validity of the tool in light of controversial views about the BMI and other factors as indicator of nutritional status.
MUST is a five-step screening tool to identify adults who are malnourished, at risk of malnutrition (undernutrition), or obese. MUST is designed to detect protein-energy malnutrition.