ABSTRACT
Introduction
Uncovering the impact of medical nutrition therapy (MNT) on resulting outcomes depends on high quality standardized documentation that can be analyzed. A valid, reliable tool is necessary to evaluate documentation for quality. The Nutrition Care Process-Quality Evaluation and Standardization Tool (NCP-QUEST) was developed to evaluate nutrition care documentation quality including NCP chains, component linkages, and reassessment.
Methods
Our aim was to determine the validity and reliability of the NCP-QUEST in a sample of people with diabetes. This study is a secondary analysis of Diabetes Registry data from the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII). Sample size was derived from the Diabetes Registry data from ANDHII collected between May 2017 and June 2019 (n = 15 patient cases, 30 total encounters). Main outcomes are the validity and reliability of the NCP-QUEST. Patient cases were audited using the NCP-QUEST. Validity was evaluated using content validity index (CVI) calculations, and reliability was determined using Krippendorff’s alpha (α) coefficient and interrater correlation coefficient (ICC).
Results
The NCP-QUEST was found to have high validity (relevance: S-CVI-UA = 0.96, S-CVI-Ave=0.98; clarity: S-CVI-UA = 0.92, S-CVI-Ave=0.96), moderate interrater reliability (α = 0.6684, ICC = 0.72), and low to moderate intra-rater reliability (rater 1 α = 0.8598, rater 2 α = 0.3194). The NCP-QUEST exposed gaps in documentation of clear NCP links.
Conclusion
The NCP-QUEST was found to be valid and reliable in a sample of people with diabetes. Revisions should be considered to improve agreement reliability before incorporation into practice.
Journal of Human Nutrition and Dietetics, Volume 38, Issue 6, December 2025. Read More