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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
[Evaluation of a rapid weight estimation tool for pediatric emergencies]
Tito Andrés Ortega Toro1, Javier Sierra Abaunza1, Jorge H Botero Garcés2
1Universidad de Antioquia, Medellín, Colombia.
Insights
The Colombian Pediatric Tape (CPT) offers better pediatric weight estimation than the Broselow Tape (BT) in emergency settings. CPT demonstrated superior accuracy in a large Colombian study, improving emergency care decisions.
Area of Science:
- Pediatric emergency medicine
- Medical device performance evaluation
- Clinical biostatistics
Context:
- Accurate pediatric weight estimation is critical in emergencies.
- Existing tools like the Broselow Tape (BT) have population-specific performance limitations.
- Rapid weight estimation is vital when direct measurement is impractical.
Purpose:
- To compare the weight estimation accuracy of the Colombian Pediatric Tape (CPT) against the Broselow Tape (BT) in a pediatric population.
- To assess the concordance and prediction performance of both tapes.
- To identify the most reliable tape for emergency weight estimation in Colombian children.
Summary:
- A cross-sectional study analyzed 42,232 Colombian children using Cohen's Kappa and Bland-Altman index.
- The Colombian Pediatric Tape (CPT) showed higher concordance (Kappa 0.65) than the Broselow Tape (BT) (Kappa 0.57).
- CPT exhibited a smaller mean difference between estimated and actual weight (0.005 Kg) compared to BT (0.13 Kg), indicating superior accuracy.
Impact:
- The Colombian Pediatric Tape (CPT) provides more reliable weight estimations for pediatric emergency care in Colombia.
- Findings suggest CPT can reduce errors associated with weight overestimation or underestimation by the Broselow Tape (BT).
- Improved weight estimation accuracy can lead to more precise medication dosing and better patient outcomes in critical situations.
Abstract:
Weight measurement is essential in the treatment of pediatric patients in emergencies, however, in cases of patient instability or limited resources, weight estimation becomes a plausible alternative. There are rapid estimation methods, although with performance discrepancies in different populations.
Objective:
To compare the performance of the "Colombian Pediatric Tape" (CPT) and Broselow Tape (BT) in weight estimation in children.
Patients And Method:
Descriptive cross-sectional study and concordance analysis. Sample of 42,232 children from the 2010 National Survey of the Nu tritional Situation of Colombia. For the performance evaluation, the prediction of zones and weight of each tool and their concordance using the Kappa coefficient and the Bland-Altman index were considered.
Results:
Cohen's Kappa index for the BT with respect to the color area agreement was 0.57 and for the CPT it was 0.65. The Bland-Altman index for CPT of the actual weight and the esti mated weight showed a mean difference of 0.005 Kg (CI95; -4.1 to +4.1), and for the BT was 0.13 Kg (CI95; -5.2 to 5.5). The percentage difference analysis of concordance between the two tools showed a statistically significant overall difference in favor of the CPT, 66% Vs 70% (p = 0.00001).
Conclusions:
In Colombian children, the BT overestimates or underestimates the weight by up to 21% with respect to the real value, while CPT can be used with better performance to estimate the weight.
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