Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA: Simple tools for a critical measure

Yeyi Zhu, Ladia M. Hernandez, Yongquan Dong, John H. Himes, Laura Caulfield, Jean M. Kerver, Lenore Arab, Paula Voss, Steven Hirschfeld, Michele R. Forman

Research output: Contribution to journalArticle

Abstract

ObjectiveIn resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).DesignCross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).SettingNational Children's Study-Formative Research in Anthropometry (2011-2012).SubjectsMulti-racial/ethnic infants and children aged <6 years (n 1473).ResultsDeveloped Models 1-4 had high predictive precision (R2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas ('1·7, 9·2 and '4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.ConclusionsUlna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.

Original languageEnglish (US)
JournalPublic Health Nutrition
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Weights and Measures
Forearm
Ulna
Pediatrics
Anthropometry
Resuscitation
Research

Keywords

  • Anthropometric measure
  • Estimation
  • Forearm
  • Paediatric weight
  • Ulna

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

Cite this

Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA : Simple tools for a critical measure. / Zhu, Yeyi; Hernandez, Ladia M.; Dong, Yongquan; Himes, John H.; Caulfield, Laura; Kerver, Jean M.; Arab, Lenore; Voss, Paula; Hirschfeld, Steven; Forman, Michele R.

In: Public Health Nutrition, 01.01.2018.

Research output: Contribution to journalArticle

Zhu, Yeyi ; Hernandez, Ladia M. ; Dong, Yongquan ; Himes, John H. ; Caulfield, Laura ; Kerver, Jean M. ; Arab, Lenore ; Voss, Paula ; Hirschfeld, Steven ; Forman, Michele R. / Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA : Simple tools for a critical measure. In: Public Health Nutrition. 2018.
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abstract = "ObjectiveIn resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).DesignCross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).SettingNational Children's Study-Formative Research in Anthropometry (2011-2012).SubjectsMulti-racial/ethnic infants and children aged <6 years (n 1473).ResultsDeveloped Models 1-4 had high predictive precision (R2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 {\%}) v. the APLS, Theron and Traub-Johnson formulas ('1·7, 9·2 and '4·9 {\%}, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 {\%}). Further, Models 1-4 were within 10 and 20 {\%} of actual weight in 72-87 and 95-99 {\%} of the weight estimations, respectively, which outperformed any of the three existing methods.ConclusionsUlna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.",
keywords = "Anthropometric measure, Estimation, Forearm, Paediatric weight, Ulna",
author = "Yeyi Zhu and Hernandez, {Ladia M.} and Yongquan Dong and Himes, {John H.} and Laura Caulfield and Kerver, {Jean M.} and Lenore Arab and Paula Voss and Steven Hirschfeld and Forman, {Michele R.}",
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T1 - Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA

T2 - Simple tools for a critical measure

AU - Zhu, Yeyi

AU - Hernandez, Ladia M.

AU - Dong, Yongquan

AU - Himes, John H.

AU - Caulfield, Laura

AU - Kerver, Jean M.

AU - Arab, Lenore

AU - Voss, Paula

AU - Hirschfeld, Steven

AU - Forman, Michele R.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - ObjectiveIn resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).DesignCross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).SettingNational Children's Study-Formative Research in Anthropometry (2011-2012).SubjectsMulti-racial/ethnic infants and children aged <6 years (n 1473).ResultsDeveloped Models 1-4 had high predictive precision (R2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas ('1·7, 9·2 and '4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.ConclusionsUlna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.

AB - ObjectiveIn resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).DesignCross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).SettingNational Children's Study-Formative Research in Anthropometry (2011-2012).SubjectsMulti-racial/ethnic infants and children aged <6 years (n 1473).ResultsDeveloped Models 1-4 had high predictive precision (R2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas ('1·7, 9·2 and '4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.ConclusionsUlna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.

KW - Anthropometric measure

KW - Estimation

KW - Forearm

KW - Paediatric weight

KW - Ulna

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