Construction of a nutritional assessment tool for the pediatric cancer population (ANPEDCancer): content validation using the Delphi method

OBJECTIVE: To develop and establish content validation of a nutritional assessment tool for pediatric cancer patients using the Delphi method. METHODS: A literature review was performed and the nutritional assessment in pediatrics and cancer construct was discussed with experts. Forty-six nutrition experts from Brazil with experience in oncology participated in the panel. Rounds were held to discuss and judge the items that should be included in this tool. With the aid of an algorithm, it was possible to simultaneously consider the adequacy, relevance and measurement of the items. The consensus was reached with an agreement equal to or greater than 80% among the experts. RESULTS: From the 7 domains suggested by the literature, the first round generated 81 items, which were assessed for adequacy, relevance and the possibility of being measured in the routine of nutritional assessment, by specialists in the following two rounds. The percentage of specialists who responded to each round was high (above 90%) and the dropout rate between the stages was relatively low. After applying the algorithm, the ANPEDCancer tool had 36 items considered appropriate by specialists from the five different geographical regions of Brazil. CONCLUSIONS: The Delphi method allowed the construction and content validation of the nutritional assessment tool for children and adolescents with cancer, providing the first stage for use in the Brazilian hospital setting.