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Determining growth faltering with a tracking score
Edward A Frongillo1, Gail E Rothe1, Jennifer K J Lambert1
1Division of Nutritional Sciences, Savage Hall, Cornell University, Ithaca, New York 14853.
Insights
A new tracking score effectively identifies growth faltering in children. This method is more accurate than existing scores for assessing child growth and development.
Area of Science:
- Pediatrics
- Child Health
- Growth Monitoring
Background:
- Child growth faltering is a critical indicator of health and development.
- Accurate assessment tools are essential for early intervention.
Purpose of the Study:
- To develop and validate a novel tracking score for identifying growth faltering in children.
- To compare the accuracy of the new tracking score against commonly used growth assessment methods.
Main Methods:
- A tracking score was developed and tested on a sample of Guatemalan children (9-24 months).
- Graphical methods were used for visual classification of growth faltering.
- Receiver Operating Characteristic (ROC) curves were employed to compare the accuracy of various scores, including the new tracking score, increment score, residual score, and growth-curve parameter score.
Main Results:
- The tracking score demonstrated higher accuracy in identifying growth faltering compared to other tested scores, particularly for length.
- An intermediate version of the tracking score, utilizing specific measurement intervals, showed the highest accuracy for both weight and length faltering.
- The growth-curve parameter score exhibited the lowest accuracy among all evaluated methods.
Conclusions:
- The developed tracking score is a reliable and accurate tool for detecting growth faltering in children.
- This score offers advantages such as ease of calculation, interpretability, and the ability to integrate multiple growth measurements.
- The tracking score is a promising indicator for monitoring child growth and facilitating timely interventions.
Abstract:
A tracking score for determining growth faltering in children was developed and tested. A graphical method was developed for classifying by visual inspection whether or not a given child had faltered in growth. This method was used to classify all children in a sample of Guatemalan children as to faltering in both weight and length between 9 and 24 months of age; 80 of 345 children had faltered in weight, and 44 of 336 children had faltered in length. The accuracies for determining this faltering of seven versions of the tracking score and that of three other commonly used scores were assessed and compared using ROC curves, the areas under the curves, and two other ways. The other scores tested were the increment score, the residual score, and a growth-curve parameter score. The accuracies of the scores were overall lower for weight than for length. For both weight and length, the growth-curve parameter score had the lowest accuracy, and the tracking score that used an intermediate number of measurements (four in the interval of interest and three in the previous interval) had the highest accuracy. The tracking score has a number of features that make it attractive as an indicator of faltering. It is easy to calculate and interpret, preserves magnitude and direction, incorporates several growth measurements into a single indicator of faltering, gives equal weight to the information in all the measurements used, allows for missing measurements, and can be generalized to include other aspects of growth.
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