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Weight velocity equations with 14-448 days time separated weights should not be used for infants under 3 years of age
Martin J C van Gemert1, Cornelis M A Bruijninckx2, H A Martino Neumann3
1Department of Biomedical Engineering & Physics, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Insights
Shorter time intervals in infant weight velocity calculations decrease accuracy, especially with weight fluctuations. Software predictions for infant growth issues require mandatory clinical verification under three years old.
Area of Science:
- Pediatrics
- Medical Informatics
- Biostatistics
Background:
- Accurate infant growth monitoring is crucial for identifying potential health issues.
- Previous methods using long time intervals (448 days) for weight velocity calculations were found to be erroneous.
- The hypothesis posits that shorter time intervals negatively impact the accuracy of infant weight velocity calculations.
Purpose of the Study:
- To test the hypothesis that shorter time separations decrease the accuracy of numerical weight velocity equations in infants up to three years old.
- To analyze the impact of varying time intervals (X) on the accuracy of two-time-points weight velocity calculations.
- To evaluate the influence of realistic infant weight fluctuations on velocity prediction accuracy.
Main Methods:
- Systematic variation of time interval (X) from 1 to 448 days using standard weight curves (P50/0SD).
- Analysis of weight velocities with weights separated by 1 day and variable intervals.
- Inclusion of typical infant weight fluctuations and clinical case data in the analysis.
Main Results:
- Shorter time intervals (X) significantly decrease the accuracy of weight velocity predictions in children under three years.
- The combination of weight fluctuations and variable time intervals exacerbates inaccuracy for shorter X values.
- These inaccuracies are inherent in naturally occurring infant weight patterns and measurement intervals.
Conclusions:
- The study supports the hypothesis that shorter time separations reduce the accuracy of infant weight velocity calculations.
- Existing software relying on these calculations for infant growth prediction (under three years) should be reconsidered or abandoned.
- Clinical verification is essential when software indicates potential infant growth disorders, using methods like comparing predicted to exact velocities.
Abstract:
Abnormal growth of infants may indicate disease of the children, thus methods to identify growth disorders are wanted in medicine. We previously showed that two-time-points weight growth velocities at age t, calculated by a commercial software product as [Weight(t) - Weight(t - X)]/X, with X = 448 days, were erroneous due to the long separation of 448 days. We were convinced that shorter X-values would solve this accuracy problem. However, our hypothesis is that: "shorter time separations than 448 days cause a decreased accuracy of numerical weight velocity equations in realistic infant weights until an age of about three years". Supporting evidence comes from analyzing how shorter X-values will affect the accuracy of two-time-points weight velocity calculations. We systematically varied X between 1 and 448 days of various P50/0SD-related standard weight curves: (a) P50/0SD with the weights separated by 1 day and X = 1,28,224,448 days; (b) P50/0SD with the weights at variable ages and X = 14-448 days; and (c) case (b) and incorporating weight fluctuations typically occurring in infants. Cases (b) and (c) include details observed in a clinical case. Our results show that the combination of weight fluctuations and varying time intervals between consecutive weights make weight velocity predictions worse for shorter X values in children younger than three years. Because these two causes of failure occur naturally in infants whose weight is regularly measured, other weight velocity equations face the same causes for inaccuracy. In conclusion, our hypothesis suggests that any software that predicts weight velocities should be abandoned in infants < 3 years. Practically, it should require that when (commercial) software weight velocity prediction suggests a medical problem, careful clinical checking should be mandatory, e.g. by linking predicted and exact weight velocities at age t (the latter from the mathematical first derivative at age t of standard weight curves).
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