Comparison of Broselow tape measurements versus physician estimations of pediatric weights
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Updated: Jun 9, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Marcy Rosenberg1, Sarah Greenberger, Amit Rawal
1Emergency Department, Orlando Health, Orlando FL, USA. marcyrosenberg@gmail.com
Insights
The Broselow tape is generally accurate for estimating pediatric weight, but less so for obese children. Physician estimates alone are less accurate than the Broselow tape.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Measurement Accuracy
Background:
- Accurate weight estimation is critical for pediatric emergency medicine.
- The Broselow tape is a commonly used tool for estimating pediatric weight in emergencies.
- Physician visual estimation is an alternative method for determining pediatric weight.
Purpose of the Study:
- To compare the accuracy of physician weight estimates versus Broselow tape measurements in children.
- To evaluate if physician-adjusted Broselow tape measurements improve weight estimation accuracy.
Main Methods:
- Cross-sectional study in a pediatric emergency department.
- Included children aged 0-14 years.
- Compared Broselow tape measurements, physician estimates, and physician-adjusted (hybrid) estimates against actual weights.
Main Results:
- Broselow tape estimates were within 10% of actual weight 63% of the time.
- Physician estimates were within 10% 43% of the time, and hybrid estimates 55% of the time.
- The Broselow tape was less accurate for obese children compared to physician estimates.
Conclusions:
- The Broselow tape generally provides better agreement with actual pediatric weight than physician visual estimation.
- Physician adjustment of Broselow tape measurements did not significantly improve accuracy compared to the tape alone.
- Accuracy for obese children remains a challenge for both methods.
Objective:
We sought to determine the agreement of physician estimates compared with Broselow tape measurements in accurately determining children's weights. Our secondary objective was to evaluate whether physician adjustment of the Broselow tape weight measurement is a better estimate of pediatric weight compared with either method alone.
Methods:
This cross-sectional study was conducted in the emergency department (ED) of a tertiary children's hospital. Children between the ages of 0 and 14 years consecutively registered in the pediatric ED were eligible for enrollment. Height, weight, body mass index, and Broselow tape measurement were obtained for all subjects. Blinded ED physicians provided estimates for weight and body habitus for enrolled subjects. Physicians next were given the Broselow weight measurement and then submitted a second, amended estimate (hybrid). Percentage differences were used to analyze the discrepancy between estimates and actual weight. Specifically examined were the proportion of estimates that fell within 10% of the patients' actual body weights.
Results:
A total of 372 subjects met the inclusion criteria. Mean age was 45.7 months, mean body mass index was 17.4, mean weight was 16.8 kg, and 39 participants (18.1%) met the definition for obese. Broselow estimates were within 10% of actual weight 63% of the time, physician estimates were within 10% of the actual weight 43% of the time and hybrid estimates 55% of the time. Based on average mean percent error, compared with actual weight, Broselow differed by 10.8% (95% confidence interval [CI], 9.7-12), hybrid estimate by 11.3% (95% CI, 10.3-12.2), and physician estimate by 16.2% (95% CI, 14.7-17.7). The Broselow tape was significantly worse than physician estimate for obese patients: 26.4% (95% CI, 19.7-33.1) versus 16.0% (95% CI, 12.3-19.8).
Conclusion:
The Broselow tape generally has greater agreement with actual weight than physician visual estimation, except for obese children. Physician adjustment of the Broselow measurement also proved to be comparable to the Broselow tape.
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