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Inter-rater variability and validity of the Clinical Assessment of Nutrition Score (CANS) in term newborns.

Aparna Jayaraman*, Sunitha Pazhaniandi, Shobhana Sivathanu

Aim: To assess the inter-observer reliability and validity of the CANScore (Clinical Assessment of Nutrition Score) compared to other anthropometric parameters namely, Ponderall Index, MAC:HC and BMI. Materials and Methods: Nighty eight term newborns with no medical complications were included. Ponderall Index, MAC:HC (Midarm Circumference to Head Circumference ratio) and BMI (Body Mass Index) were assessed. Two observers applied the CANScore individually on every neonate. At the end of the study, the scores of both the raters were entered in a datasheet and compared statistically. Results: Prevalence of Fetal malnutrition (FM) based on CANSore was ~59% in the study group. Inter-rater reliability of the CANScore was found to be fair to good but not excellent. CANScore had a good sensitivity and specificity compared with BMI (86.2 % and 75% respectively, AUC: 0.853). Conclusion: Inter- observer variability of CANScore is fair to good but not excellent. It has the highest sensitivity and specificity when compared with the BMI. CANScore alone may not accurately assess the fetal malnutrition.