Multifactor Screener: Validation Results

RFMMB staff have assessed the validity of the Multifactor Screener in several studies: NCI's Observing Protein and Energy (OPEN) Study, the Eating at America's Table Study (EATS), and the joint NIH-AARP Diet and Health Study. In all studies, multiple 24-hour recalls in conjunction with a measurement error model were used to assess validity. In general, the validation results reflect the Multifactor Screener's hierarchical design -- fruit and vegetable intake was estimated best by the screener, followed by percentage energy from fat, and lastly grams of fiber.

In the OPEN Study, estimates of median intake were:

• Pyramid Servings of Fruits and Vegetables:
  • Men: recalls - 6.3; screener - 5.3;
  • Women: recalls - 5.4; screener - 4.7.
• Percentage Energy from Fat:
  • Men: recalls - 31.8; screener - 32.0;
  • Women: recalls - 32.0; screener - 30.5.
• Fiber:
  • Men: recalls - 21.2; screener - 18.3;
  • Women: recalls - 16.5; screener - 14.1.

These validation results suggest that dietary exposure estimates computed for the Cancer Control Supplement may be useful to compare subgroup means, especially for populations consuming mainstream diets. The estimates may be less useful for populations with more ethnic diets, including Asian and possibly Latino populations.

At the individual level, correlations between the screener and estimated true intake ranged from 0.54 (fiber for men) to 0.76 (Pyramid servings of fruits and vegetables for women); about 25 to 50 percent of the variability in the true intake will be captured by the screener questions. Thus, although significant error may be associated with these estimates of diet, we believe the exposure estimates still substantially reflect what individuals are actually consuming.

Validation results are reported in detail in:

Thompson FE, Midthune D, Subar AF, Kahle LL, Schatzkin A, Kipnis V. Performance of a short tool to assess dietary intakes of fruits and vegetables, percentage energy from fat and fibre. Public Health Nutr 2004 Dec;7(8):1097-105. [View Abstract]