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 percent energy from fat, and lastly grams of fiber.
In the OPEN Study, estimates of median intake were:
- Servings of Fruits and Vegetables:
- Men: recalls - 6.3; screener - 5.3;
- Women: recalls - 5.4; screener - 4.7.
- Percent 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 (CCS) 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 (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.
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