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Validity of Broselow tape for estimating weight of Indian children
Vivek Shah1, Sandeep B Bavdekar1
1Department of Pediatrics, TN Medical College & BYL Nair Charitable Hospital, Mumbai, India.
Insights
The Broselow tape overestimated weight in most Indian children, particularly in heavier groups. Applying a 10% correction factor improved accuracy, making it a better tool than APLS methods for estimating pediatric weight.
Area of Science:
- Pediatric Emergency Medicine
- Medical Device Validation
- Clinical Biometrics
Background:
- The Broselow tape is a widely used tool for estimating pediatric weight to determine appropriate drug dosages and equipment sizes in emergencies.
- Previous validation studies have primarily focused on Western populations, necessitating evaluation in diverse ethnic groups like Indian children.
- Inaccurate weight estimation can lead to critical errors in pediatric emergency care.
Purpose of the Study:
- To assess the accuracy of the Broselow tape in estimating the actual weight of Indian children.
- To determine the relationship between actual weight and Broselow tape-predicted weight in this population.
- To derive a potential equation for improved weight determination based on height for Indian children.
Main Methods:
- A cross-sectional study involving 210 Indian children categorized into three weight groups (<10 kg, 10-18 kg, >18 kg).
- Comparison of actual measured weight with Broselow tape-predicted weight, calculating percentage differences and zone agreement.
- Correlation analysis using Pearson's coefficient against Advanced Pediatric Life Support (APLS) and updated APLS formulae.
Main Results:
- The Broselow tape showed mean percentage differences of -11.78% (<10 kg), -17.09% (10-18 kg), and -14.27% (>18 kg).
- Color-coded zone agreement varied (33.3% to 33.9%), with only 21.08% agreement within 10% for the 10-18 kg group.
- A 10% correction factor improved accuracy, achieving 55.70%-79.2% agreement; Broselow tape correlation (r=0.89) surpassed APLS methods (r=0.68-0.76).
Conclusions:
- The Broselow tape tends to overestimate weight in the majority of Indian children, especially in the 10-18 kg and >18 kg groups.
- Applying a 10% weight correction factor to Broselow tape estimations may enhance accuracy for Indian pediatric populations in public hospitals.
- The Broselow tape demonstrated a stronger correlation with actual weight compared to APLS and updated APLS formulae in this study.
Background & Objectives:
The Broselow tape has been validated in both ambulatory and simulated emergency situations in the United States and is believed to reduce complications arising from inaccurate drug dosing and equipment sizing in paediatric population. This study was conducted to determine the relationship between the actual weight and weight determined by Broselow tape in the Indian children and to derive an equation for determination of weight based on height in the Indian children.
Methods:
This cross-sectional study was conducted at a tertiary care hospital in Mumbai, India. The participants' weights were divided into three groups <10 kg, 10-18 kg and >18 kg with a total sample size estimated to be 210 (70 in each group). Using the tape, the measured weight was compared to Broselow-predicted weight and percentage weight was calculated. Accuracy was defined as agreement on Broselow colour-coded zones, as well as agreement within 10 per cent between the measured and Broselow-predicted weights. The resulting data were compared with weights estimated by advanced paediatric life support (APLS) and updated APLS formulae using Pearson's correlation coefficient.
Results:
The mean percentage differences were -11.78, -17.09 and -14.27 per cent for <10, 10-18 and >18 kg weight-based groups, respectively. The Broselow colour-coded zone agreement was 33.3 per cent in children weighing <10 kg, but only 7.4 per cent in the 10-18 kg group and 33.9 per cent in the >18 kg group. Agreement within 10 per cent was 53.13 per cent for the <10 kg group, but only 21.08 per cent for the 10-18 kg group and 33.9 per cent for the >18 kg group. Application of 10 per cent weight correction factor improved the percentages to 79.2 per cent for the <10 kg category, to 55.70 per cent for the 10-18 kg group and to 61.0 per cent for the >18 kg group. The correlation coefficient between actual weight and weights estimated by Broselow tape (r=0.89) was higher than that between actual weight and weight estimated by APLS method or updated APLS formulae (r=0.68) in 12-60 months age group as well as in >60 months age group (r=0.76).
Interpretation & Conclusions:
Broselow weight overestimated weight by >10 per cent in majority of Indian children. The weight overestimation was greater in children belonging to over 18 and 10-18 kg weight groups. Applying 10 per cent weight correction factor to the Broselow-predicted weight may provide a more accurate estimation of actual weight in children attending public hospital. Weights estimated using Broselow tape correlated better with actual weights than those calculated using APLS and updated APLS formulae.
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