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The interobserver reproducibility of bioelectrical impedance analysis measurements in infants and toddlers
C Vettorazzi1, E Smits, N W Solomons
1Center for Studies of Sensory Impairment, Aging, and Metabolism, Research Branch, Dr. Rodolfo Robles V Hospital, Guatemala City, Guatemala.
Insights
Bioelectrical impedance analysis (BIA) can reliably measure body composition in sick children. Properly trained observers can achieve reproducible weight, resistance (R), and reactance (Xc) measurements, overcoming previous concerns about using BIA in this population.
Area of Science:
- Pediatric Nutrition
- Biomedical Engineering
- Anthropometry
Background:
- Bioelectrical impedance analysis (BIA) is a method for estimating body composition.
- Previous reluctance to use BIA in young children stemmed from concerns regarding irritability, measurement instability, electrode placement, and reproducibility.
- Emerging nomograms for adults and children exist, but application in very young or ill children remains challenging.
Purpose of the Study:
- To evaluate the precision and reproducibility of independent bioelectrical impedance analysis (BIA) measurements in malnourished children.
- To assess the feasibility of using BIA for body composition assessment in a pediatric population experiencing nutritional recuperation.
Main Methods:
- Two independent observers conducted a series of measurements on four malnourished children over 10 days.
- Measurements included weight, resistance (R), and reactance (Xc) using BIA.
- Data analysis focused on comparing measurements between observers and calculating the coefficient of variation (CV) for weight.
Main Results:
- The coefficient of variation (CV) for weight measurements was 3.5% for observer A and 3.8% for observer B.
- No significant differences were found in the means of weight, R, and Xc measurements between the two observers.
- The study demonstrated high consistency in BIA and weight measurements.
Conclusions:
- Properly trained observers adhering to standardized protocols can obtain equivalent and reproducible BIA and weight data in sick children.
- These findings support the potential utility of BIA for monitoring body composition changes in pediatric populations, even in challenging clinical situations.
- The study addresses previous limitations and suggests BIA is a viable tool for pediatric nutritional assessment.
Abstract:
Although nomograms to convert readings of resistance (R) and reactance (Xc) into estimates of body composition have begun to emerge for children as well as adults, there has been reluctance to use bioelectrical impedance analysis (BIA) in very young children due to the irritability of children, measurement instability, positioning of electrodes, and, of course, reproducibility of measurements. The precision of completely independent measurements of BIA indices was evaluated by two observers by comparing a series of 40 measurements of R and Xc and 36 measurements for weight in four malnourished children on 10 different days during the course of their nutritional recuperation. For weight, the CV (coefficient of variation) was 3.5% for observer A and 3.8% for observer B. There were no differences in the means across observers with respect to weight, R, and Xc. The results obtained in this study illustrate that properly trained observers following the same standards can produce equivalent data for BIA and weight measurements even in sick children.