Development of a liver cirrhosis-specific nutrition-focused physical examination tool: A modified Delphi…

StudyNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition· Jul 2026

Development of a liver cirrhosis-specific nutrition-focused physical examination tool: A modified Delphi study.

Rucha Modak, Alainn Bailey, Laura Byham-Gray, Diane Rigassio Radler

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GastroenterologyStudyQ2IF 2.8

Expert panel reached consensus on 56 of 63 proposed cirrhosis nutrition exam components.

Development of a liver cirrhosis-specific nutrition-focused physical examination tool: A modified Delphi study.

Rucha Modak … Diane Rigassio Radler

Nutrition in clinical practice · Jul 2026 · Q2 in General Medicine

Background

Malnutrition in the form of protein-energy deficits and altered micronutrient status is associated with liver cirrhosis (liver cirrhosis).

Purpose

The study aimed to identify physical findings associated with malnutrition in adult patients with liver cirrhosis and to develop an liver cirrhosis-specific nutrition-focused physical exam (liver cirrhosis-specific NFPE) tool.

Methods

Panelists were recruited through purposive sampling.

n = 16

Results

56

56 of 63 proposed exam components reached expert consensus for the final tool

n = 16

More results

Panelists (N = 16) were ≥25 years of age, 93.75% had a Masters' degree or higher, and 100% reported using NFPE in practice.

More results

The 8 NFPE domains that achieved consensus were identified through an evidence-based literature search and include Anthropometrics, Vital Signs, Musculoskeletal and Adipose Exam, Orofacial Exam, Hair, Skin, and Nails Exam, Gastrointestinal Exam, Nervous System Exam, and Disease-specific Exam.

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Conclusion · 1 of 2

Specific domains and components for an evidence-based liver cirrhosis-specific NFPE tool were identified by obtaining consensus from a panel of expert RDs.

Conclusion · 2 of 2

This tool may further be developed and validated to assist in comprehensive nutritional assessment of patients with liver cirrhosis.

Development of a liver cirrhosis-specific nutrition-focused physical examination tool: A modified Delphi study.

Development of a liver cirrhosis-specific nutrition-focused physical examination tool: A modified Delphi study.

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