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Importance:
A simple, reliable anthropometric tool for rapid estimation of weight in children would be useful in limited-resource settings where current weight estimation tools are not uniformly reliable, nearly all global under-five mortality occurs, severe acute malnutrition is a significant contributor in approximately one-third of under-five m...
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Importance
A simple, reliable tool for rapid estimation of weight in children would be useful in limited-resource settings where current weight estimation tools are not reliable, nearly all global under-five mortality occurs, severe acute malnutrition is a significant contributor in approximately one-third of under-five mortality, and a weight scal...
Citations
... En escenarios de reanimación cuando optimizar el tiempo es esencial o cuando las herramientas no están disponibles en sitios de bajos recursos económicos (ej., no disposición de balanzas, cunas o camas con balanzas incluidas) es un reto determinar el peso exacto y con ello la dosis de fármacos, cardioversión o desfibrilación, y tamaño de los dispositivos médicos a utilizar. Convirtiendo a los métodos para estimar de manera rápida y económica el peso una alternativa real y de uso ampliamente distribuido 15,16 . Uno de esos métodos es la CB; sin embargo, estudios han reportado imprecisión en la estimación de peso usando la CB dependiendo la región geográfica de su aplicación, como en el estudio de Milne, W. et al, con 6.361 niños(as) donde se encontró que la CB tuvo una diferencia media de 7,1% 21 , mientras que Asskaryar y Shankar en su cohorte de 1185 niños(as), con edades de 1 mes a 12 años en la India reportaron que la CB sobreestima el peso en un 5-15% dependiendo de la zona de color 22 ; Khouli M, describió en una muestra de 815 niños(as) mexicanos, una diferencia del peso medido con relación al calculado en la CB en más de 10% 11 ; también se han reportado mayores diferencias usando la CB, con una diferencia media de 1,62 kilos 21 . ...
Objetivo:
Comparar el desempeño de la “Cinta Pediá trica Colombiana” (CPC) y Cinta de Broselow (CB) en la estimación del peso en pediatría.
Pacientes y Método:
Estudio descriptivo de corte trasversal y de análisis de concordancia. Muestra de 42.232 niños(as) de la Encuesta Nacional de Situación Nutricional de Colombia de 2010. Para la evaluación del desempeño se tuvo en cuenta la predicción de zonas y peso de cada herramienta y su concordan cia mediante el coeficiente Kappa y el índice de Bland-Altman.
Resultados:
El índice Kappa de Cohen para la CB respecto a la concordancia del área de color fue de 0,57 y para la CPC fue del 0,65. El índice de Bland-Altman para la CPC del peso real y el peso estimado mostró una diferencia media de 0,005 Kg (IC95; -4,1 a +4,1), y para la CB de 0,13 Kg (IC95; -5,2 a 5,5). El análisis de diferencia de por centajes de concordancia entre las dos herramientas mostró una diferencia global estadísticamente significativa a favor de la CPC, 66% vs 70% (p = 0,00001).
Conclusiones:
En niños(as) colombianos la CB sobreestima o subestima el peso hasta en 21% comparado con el valor real, mientras la CPC se puede utilizar con mejor desempeño para estimar el peso.
... A measure of wasting or acute malnutrition, MUAC functions in emergencies it determines the prevalence of malnutrition as a quick alternative to WFH, also act as 1st phase screening for selecting feeding intervention such as Supplementary Feeding Programs (SFP)or therapeutic feeding centers (TFCs) finally to admit children to TFCs [4,38]. The 1978 National Center for Health Statistics (NCHS) international reference was used to calculate nutrition indices among children 0-6 months till 2006 [22,48,49] when WHO introduced a new growth standard (WHO GS) endorsed in 2009 by WHO and UNICEF for identification of severe acute malnutrition [48]. Cut-off points presented as Z-scores (also called standard deviation (SD) scores) [4], furthermore, in the year, WHO/UNICEF also approved the cut-off point of MUAC <115 mm/11.5 cm (previously the cut-off was 110 mm/11.0 ...
Severe Acute Malnutrition (SAM) is a major silent killer among children under five years of age, in low resources settings. It’s also being regarded as a disease of hungry communities. Therefore, to assess and classify an individual nutritional status under SAM is by anthropometry that determines body measurement. Measurable variables, age, sex, weight, height and Mid-Upper Arm-Circumference (MUAC) for children 6-59 months. SAM characterized with visible wasting and bilateral edema, in infants <6 months. However, social criteria like the absence of a mother or inadequacy of breastfeeding predict nutritional risk. Once more, SAM in U5 assessed by nutritional indices of Weight-For-Height (WFH), MUAC, and bilateral edema. Children 5-19 years BMI-for-age plus clinical signs are used. MUAC preferable during pregnancy. WHO Growth Standards of 2007 suggested over NCHS 1978. Nutrition indices in Z-scores opposed to median percentage. Median off use in classifying individual’s nutritional status. Methods and protocols for assessment of children 6-59 months are more developed than for other age. Therefore, best practice to produce functional outcomes is needed. The level of malnutrition at admission phase influences hospitals stay. Evidence suggests that malnutrition is more frequent and severe among males than females. Implications, no special consideration in severe acute malnutrition admitted in a critical phase”. Protocols to discharge patients upon recovery needs harmonization. MUAC misdiagnose Kwashiorkor children due to fluid retention but remains a reliable tool. Ready to Use Therapeutic Food (RUTF) used for management of SAM. The study aimed to evaluate the effectiveness of screening tools, therapeutic interventions and shed light on the risk factors associated with SAM. A later effect includes but not limited to mental retardation, poor school performance, and low self-esteem.
... Among children aged 6-59 months, AM is most often measured and identified using weight-for-age (WAZ), weight-for-height or weight-for-length (WLZ) z-scores and/or a measure of mid-upper arm circumference (MUAC) (24) . However, inconsistencies between these tools are well documented within the literature (25) . Given the availability of different anthropometric indicators of malnutrition (i.e. ...
... In relation to the study's second objective, results of the bivariate and multivariate analyses indicated that admittance to MAMI, in practice, was most strongly associated with the use of the MUAC criterion of scores < 115 mm. Although amongst the literature, MUAC is recognised as a reliable measure among children aged 6-59 months valued for its simplicity, accuracy, reproducibility and affordability (25,43,44) , it has also been criticised for its strong association with gender, age and stunting therefore negatively affecting its validity (25) . Consistent with internationally recognised guidelines, U6M that met this criterion (MUAC < 115 mm) were 366 times more likely to be admitted than those that did not, controlling for sex, age and all other anthropometric measures. ...
... In relation to the study's second objective, results of the bivariate and multivariate analyses indicated that admittance to MAMI, in practice, was most strongly associated with the use of the MUAC criterion of scores < 115 mm. Although amongst the literature, MUAC is recognised as a reliable measure among children aged 6-59 months valued for its simplicity, accuracy, reproducibility and affordability (25,43,44) , it has also been criticised for its strong association with gender, age and stunting therefore negatively affecting its validity (25) . Consistent with internationally recognised guidelines, U6M that met this criterion (MUAC < 115 mm) were 366 times more likely to be admitted than those that did not, controlling for sex, age and all other anthropometric measures. ...
Objectives
To determine (i) whether distinct groups of infants under 6 months old (U6M) were identifiable as malnourished based on anthropometric measures and if so to determine the probability of admittance to GOAL Ethiopia’s Management of At Risk Mothers and Infants (MAMI) programme based on group membership; (ii) whether there were discrepancies in admission using recognised anthropometric criteria, compared with group membership and (iii) the barriers and potential solutions to identifying malnutrition within U6M.
Design
Mixed-methods approaches were used, whereby data collected by GOAL Ethiopia underwent: factor mixture modelling, χ ² analysis and logistic regression analysis. Qualitative analysis was performed through coding of key informant interviews.
Setting
Data were collected in two refugee camps in Ethiopia. Key informant interviews were conducted remotely with international MAMI programmers and nutrition experts.
Participants
Participants were 3444 South-Sudanese U6M and eleven key informants experienced in MAMI programming.
Results
Well-nourished and malnourished groups were identified, with notable discrepancies between group membership and MAMI programme admittance. Despite weight for age z -scores (WAZ) emerging as the most discriminant measure to identify malnutrition, admittance was most strongly associated with mid-upper arm circumference (MUAC). Misconceptions surrounding malnutrition, a dearth of evidence and issues with the current identification protocol emerged as barriers to identifying malnutrition among U6M.
Conclusions
Our model suggests that WAZ is the most discriminating anthropometric measure for malnutrition in this population. However, the challenges of using WAZ should be weighed up against the more scalable, but potentially overly sensitive and less accurate use of MUAC among U6M.
... This leads to a greater degree of overestimation when used in areas with a prevalence of underweight children from resource-limited settings. [18][19][20][21] Given the risk of under-or overestimation of a child's weight, the newest generation of weight estimation methods based on length and habitus were developed. These two-dimensional systems include the PAWPER tape, Mercy method, and Wozniak method. ...
Objective
This study aims to compare the actual weights of Filipino children with their estimated weights obtained from the Broselow tape and the Pediatric Advanced Weight Prediction in the Emergency Room eXtra Length‐Mid‐arm Circumference (PAWPER XL‐MAC) tape.
Methods
A prospective, observational, cross‐sectional study conducted among Filipino children admitted at the Pediatric Emergency Department (ED) of The Medical City in Pasig City, Philippines. Mean percentage error (MPE) determined bias. Modified Bland‐Altman analysis was used to perform a visual comparison of the bias and extent of agreement. The proportion of weight estimates within 10% (p10) and within 20% (p20) of actual weight was calculated to determine the overall accuracy.
Results
A total of 220 Filipino children (63.2% male) were recruited. Both the Broselow and PAWPER XL‐MAC tapes overestimate the actual weight by an average of 0.4% (95% limit of agreement [LOA] −29.4 to 30.2) and 1.3% (95% LOA −15.3 to 17.9) respectively. Across body mass index (BMI) groups, both tapes overestimate (MPE: +19.2 and +9.3) weight among underweight children and underestimate (MPE: −13.2 and −3.5; MPE: −18.6 and −5.5) weight among overweight and obese children. In measuring estimated weight within 10% and 20% of actual weight, the PAWPER XL‐MAC performed best (79.6% and 96.8%).
Conclusion
The PAWPER XL‐MAC tape performed better as a weight estimation tool compared to Broselow tape across different age groups and BMI‐for‐age groups of Filipino children. Both tapes tend to overestimate weight among younger and underweight children while underestimating weight among ages 7 to 10 years old, overweight, or obese children.
... Average body weight of infants in Uganda =11.3 kg [32]. recorded in sorghum followed by millet, maize and sesame. ...
Mycotoxin contamination of cereals is a significant health risk for humans and animals, particularly in developing countries. To gain insight into food safety related to agricultural practices, we assessed levels of mycotoxin contamination in 105 samples of food grains raised and stored for consumption by rural households in the post-conflict districts of Kitgum and Lamwo in Northern Uganda. Aflatoxin, ochratoxin and deoxynivalenol (DON) contamination was assessed by quantitative enzyme-linked immunosorbent assay. Total aflatoxin in the foods analyzed varied from nd (not detected) to 68.2 μg/Kg. Ochratoxin ranged from 0.1 to 16.4 μg/Kg. DON ranged from nd to 2606 μg/Kg. The mean concentration of total aflatoxins was significantly higher (P = 0.002) in sorghum than in millet, maize and sesame seeds. Frequency of co-occurrence of two mycotoxins ranged from 8.3 to 100%, with the highest being aflatoxin and ochratoxin in sorghum. Co-occurrence of all three mycotoxins ranged from 8.3 to 35.3%, with the highest again being in sorghum. Mean levels of aflatoxins concentration in sorghum samples were 11.8 μg/Kg, exceeding the Ugandan national regulatory limits of 10 μg/Kg. Furthermore, 46.5% of the sorghum consumed in both districts exceeded this limit, and 86.1% of sorghum samples exceeded the European Union (E.U.) maximum tolerable limit of 4 μg/Kg. The Estimated Daily Intake (EDI) and Hazard Indices (HI) values were in the range of 1.2 × 10-5-91.521 and 1.3 × 10-7 to 0.0059, respectively. In conclusion, our results provide evidence of high levels of mycotoxin contamination and co-occurrence in food grains in Northern Uganda with aflatoxins and ochratoxins at high levels in all the cereal types analyzed. Consumption of cereals cultivated in this region poses no health risk of mycotoxins exposure since HI values obtained were less than 1.
... This resulted in a worsening of overestimation of weight in children from resource-limited settings. This has also been shown in previous studies from low-and middle-income countries and emphasises the concerns about using the Broselow tape in these settings [15][16][17]. Accuracy of the three systems in "normal weight" children. The chart shows the proportion of weight estimations falling within 10% and 20% of actual weight (p10 and p20 respectively) as well as the proportion of critical weight estimation errors (>20% error) for children with a BMI-for-age Z-score between -1.4 and 1.4. ...
Importance
The PAWPER tape system is one of the three most accurate paediatric weight estimation systems in the world. The latest version of the tape, which does not rely on a subjective assessment of habitus, is the PAWPER XL-MAC method which uses length and mid-arm circumference (MAC) to estimate weight. It was derived and validated in a population in the USA and has not yet been fully validated in a population from a resource-limited setting.
Objective
The objective of this study was to evaluate the performance of the PAWPER XL-MAC tape weight estimation system in a large dataset sample of children from resource-limited settings.
Methods
This was a “virtual” study in which weight estimates were generated using the PAWPER XL-MAC tape and Broselow tape 2007B and 2011A editions in a very large open access dataset. The dataset contained anthropometric information of children aged 6 to 59 months from standardised nutritional surveys in 51 low- and middle-income countries. The performance of PAWPER XL-MAC method was compared with the Broselow tape and a new length- and habitus-based tape, the Ralston method.
Main outcomes and measures
The bias of the weight estimation methods was assessed using the mean percentage error (MPE) and precision using the 95% limits of agreement (LOA) of the MPE. The overall accuracy was denoted by the percentage of weight estimates falling within 10% and 20% of actual weight (abbreviated as p10 and p20 respectively).
Results
The MPE (LOA) for the PAWPER XL-MAC tape, the Broselow 2007B and 2011A and Ralston method were 1.9 (-15.3, 19.2), 5.4 (-15.9, 26.7), 7.7 (-13.3, 30.5) and -0.7 (-20.2, 19.3) respectively. The p10 and p20 for each method were 79.3% and 96.9% for the PAWPER XL-MAC tape, 64.3% and 91.0% for the Broselow tape 2007B, 55.5% and 85.9% for the Broselow tape 2011A and 67.4 and 94.0% for the Ralston method respectively. The PAWPER XL-MAC system was statistically significantly more accurate than the Broselow tape 2011A, the Broselow tape 2007B and the Ralston method. The relative difference in accuracy (p10) was 43% (odds ratio 4.4 (4.4, 4.5), p<0.001), 23% (odds ratio 2.9 (2.8, 2.9), p<0.001) and 18% (odds ratio 1.8 (1.8, 1.8), p<0.001) compared to each method, respectively.
Conclusions and relevance
The PAWPER XL-MAC tape performed well in this study and was statistically significantly more accurate than both the Broselow tape editions and the Ralston method. This difference was substantial and clinically important. The tape did not perform as well at extremes of habitus-type, however, and might benefit from recalibration.
... A weight estimation tool developed from a nutritional survey database of 453,990 children aged 6 to 59 months of age in low-to-middle income countries during 1992-2006 and based on both length and MUAC was found to be more accurate and more precise than existing weight estimation methods (i.e. length-based Broselow Tape and MUAC-based Hong Kong formula) [6]. This study recalibrated and tested the accuracy and precision of this tool with a fourfold increase in nutritional survey data during 1992-2017 across a wider range of low-tomiddle income countries. ...
... Weight was estimated using Broselow Tape (BT) 2007 [B] and BT 2011 [A] to the nearest of the 26 BT weight classes (3-36 kg) using measured height in the database [13]. Weight was estimated from database MUAC and height / length using an "un-rotated" linear model initially fitted using a robust regression procedure but then "rotated" using a second linear model [6,14]. The estimation formula of the second "corrected" linear model was: ...
... This study confirmed the accuracy and precision of a weight estimation tool developed from a nutritional survey database of 453,990 children aged 6 to 59 months of age in 32 low-to-middle income countries during 1992-2006 with a database of 1,800,322 children in 51 low-to-middle income countries during 1992-2017 [5,6]. The accuracy and precision of the tool did not vary significantly by survey period (i.e. ...
Importance
A simple, reliable tool for rapid estimation of weight in children would be useful in limited-resource settings where current weight estimation tools are not reliable, nearly all global under-five mortality occurs, severe acute malnutrition is a significant contributor in approximately one-third of under-five mortality, and a weight scale may not be immediately available to healthcare professionals including first-response providers.
Objective
To test the accuracy and precision of an existing weight estimation tool based on patient height and mid-upper arm circumference (MUAC) in children between six months and five years of age in low-to-middle income countries.
Design
Data were collected in 2,434 nutritional surveys during 1992–2017 using a modified Expanded Program of Immunization two-stage cluster design.
Setting
Locations in 51 low-to-middle income countries with high prevalence of acute and chronic malnutrition.
Participants
Of 1,848,979 children enrolled in the surveys, a total of 1,800,322 children met inclusion criteria (age 6–59 months; weight ≤ 25 kg; MUAC 80–200 mm) and exclusion criterion (bilateral pitting edema and biologically implausible measurements based on WHO flagging criteria).
Exposures
Weight was estimated by a regression procedure using database height and MUAC.
Main outcomes and measures
Mean percentage difference between true and estimated weight (MPD), proportion of estimates accurate to within ± 10% and ± 20% of true weight (PW10 and PW20), weighted Kappa statistic, and Bland-Altman bias (bias) were reported as measures of tool accuracy. Standard deviation (SD) of the MPD and Bland-Altman 95% limits of agreement (LOA) were reported as measures of tool precision.
Results
The height model fitted for MUAC classes was accurate and precise. MPD was +0.67% (SD = 9.95%); PW10/PW20 were 68.31% (95% CI 68.24%, 68.38%)/94.73% (95% CI 94.69%, 94.76%); and bias (LOA) were +0.06 kg (-1.97 kg; +2.10 kg). For MUAC < 115 mm, PW10/PW20 were 63.91% (95% CI 63.42%, 64.40%)/90.72% (95% CI 90.42%, 91.01%); and bias (LOA) were +0.14 kg (-1.29 kg; +1.56 kg). For 115 mm ≤ MUAC < 125 mm, PW10/PW20 were 76.27% (95% CI 76.03%, 76.51%)/96.36% (95% CI 96.25%, 96.46%); and bias (LOA) were +0.06 kg (-1.20 kg; +1.33 kg). For MUAC > 125 mm, PW10/PW20 were 69.93% (95% CI 69.86%, 70.00%)/95.27% (95% CI 95.24%, 95.30%); and bias (LOA) were +0.05 kg (-2.04 kg; +2.13 kg).
Conclusions and relevance
An updated model estimating weight from height and MUAC in a large database of children aged 6 to 59 months across a wide range of low-to-middle income countries with high prevalence of acute and chronic malnutrition was confirmed to be accurate and precise. A height-based weight estimation tape stratified according to MUAC classes is proposed for children aged 6–59 months in limited-resource settings.
... Also, due to lack of availability, an older version of the Broselow tape was used, so we cannot comment on the accuracy of the recent version in this population; however, the newer 2011 A version, which was adjusted to reduce underestimation in obese populations, would likely have performed worse than the older version, which has been demonstrated in other low and middle-income countries. [27] Additionally, we had to contact the makers of the Mercy tape and PAWPER tapes to get access to them for this study, highlighting the need for easier accessibility of these methods for implementation into clinical practice in resource-limited settings. ...
Background:
Resuscitation of a critically-ill child requires an accurate weight for fluids and medication dosing; however, weighing children on a scale while critically ill is not always practical. The objective of this study is to determine the accuracy of three different weight estimation methods (Broselow, PAWPER XL and Mercy tape) of children presenting to Patan Hospital, Nepal.
Methods:
This was a prospective, cross-sectional study that included children presenting to the emergency department and under-fourteen outpatient clinic at Patan Hospital. Measured weight was compared to estimated weight of Broselow, PAWPER XL, and Mercy tapes. The mean percentage error and percentage of estimated weights that were within 10% (PW10) and 20% (PW20) of actual weight were calculated. Acceptable accuracy was determined as a PW10>70% and PW20>95%. A Bland-Altman analysis was done to determine agreement between each weight estimation method and actual weight.
Results:
The study included 813 children. The mean age was 4.2 years (ranging from 4 days to 14 years) with 60% male. The mean percentage error (MPE) for Broselow, PAWPER XL and Mercy were -1.0% (SD 11.8), 0.7% (10.5) and 4.2% (11.9) respectively. The predicted weight within 10% was highest for the PAWPER XL (71.5%) followed by Broselow (63.2%) and Mercy (58.1%). The predicted weight within 20% of actual weight was 95.2%, 91.5% and 91.3% for PAWPER XL, Broselow and Mercy respectively.
Conclusion:
The PAWPER XL tape was the only method found to be accurate in estimating the weight of Nepalese children.
... [14][15][16][17] Initially, MUAC was developed as a simple and practical proxy for under-nutrition in critical conditions and in emergency settings. 18 Because of its feasibility and accuracy, MUAC has been considered for early detection of overweight and obesity. In addition, the measurement of MUAC is independent of respiratory movements and postprandial abdominal distension; therefore, it may be a more reliable index than waist circumference. ...
Background:
In resource-poor settings, anthropometric parameters are evaluated as potential alternatives to the body mass index (BMI) for detecting overweight and obesity in children. To this end, the mid-upper arm circumference (MUAC) and the mid-upper arm circumference to height ratio (AHtR) were evaluated as proxies to BMI in Thai school-age children.
Study design:
An observational, cross-sectional study was performed on school-aged children.
Participants:
Children in grades 1 through 6 at all public elementary schools in the Ongkharak district, Nakhon Nayok, Thailand during May and June 2013 were included. This is a rural district with low per capita income.
Methods:
Weight, height, and MUAC were measured in school-age children and analyzed to identify optimal cut-off values for MUAC and AHtR for detection of overweight and obesity in comparison to BMI. Receiver operating characteristic (ROC) curve analysis determined the validity of MUAC and AHtR use.
Results:
Data from 3,618 children, aged 6.0-12.99 years, were analyzed. MUAC correlated with age and height (P<0.001), but especially with body weight (r = 0.888 to 0.914) and BMI (r = 0.859 to 0.908) in both genders, while AHtR correlated with body weight and BMI (P < 0.001), but not with age. Cut-off values of MUAC for obesity diagnosis ranged from 18.9 to 25.5 cm for boys and from 19.8 to 25.4 cm for girls. Accuracy was excellent for both boys (AUC = 0.952-0.991) and girls (AUC = 0.917-0.990). Cut-off of MUAC for overweight diagnosis ranged from 17.2 to 22.4 cm for boys (AUC = 0.883-0.965) and from 18.0 to 23.2 cm for girls (AUC = 0.905-0.931). AHtR cut-off values for obesity and overweight diagnosis at 0.16 and 0.145, respectively, were determined with excellent diagnostic accuracy (AUC ranged from 0.920 to 0.975).
Conclusion:
MUAC and AHtR were reliable tools to detect overweight and obesity in Thai school-age children. Cut-off points for MUAC were age-and gender-specific, while AHtR at 0.16 and 0.145 were the optimal values for both genders, independent of age. These anthropometric measurements showed excellent accuracy in predicting overweight and obesity with high specificity and sensitivity.
... There were three large database studies among those evaluated, with more than 100,000 children, one of which had more than 400,000 data points [27][28][29]. The effects of these "virtual" weight estimation studies, from very large databases, were carefully considered to establish any significant contribution to bias or distorted outcomes. ...
The safe and effective administration of fluids and medications during the management of medical emergencies in children depends on an appropriately determined dose, based on body weight. Weight can often not be measured in these circumstances and a convenient, quick and accurate method of weight estimation is required. Most methods in current use are not accurate enough, but the newer length-based, habitus-modified (two-dimensional) systems have shown significantly higher accuracy. This meta-analysis evaluated the accuracy of weight estimation systems in children. Articles were screened for inclusion into two study arms: to determine an appropriate accuracy target for weight estimation systems; and to evaluate the accuracy of existing systems using standard meta-analysis techniques. There was no evidence found to support any specific goal of accuracy. Based on the findings of this study, a proposed minimum accuracy of 70% of estimations within 10% of actual weight (PW10 > 70%), and 95% within 20% of actual weight (PW20 > 95%) should be demonstrated by a weight estimation system before being considered to be accurate. In the meta-analysis, the two-dimensional systems performed best. The Mercy method (PW10 70.9%, PW20 95.3%), the PAWPER tape (PW10 78.0%, PW20 96.6%) and parental estimates (PW10 69.8%, PW20 87.1%) were the most accurate systems investigated, with the Broselow tape (PW10 55.6%, PW20 81.2%) achieving a lesser accuracy. Age-based estimates achieved a very low accuracy. Age- and length-based systems had a substantial difference in over- and underestimation of weight in high-income and low- and middle-income populations. A benchmark for minimum accuracy is recommended for weight estimation studies and a PW10 > 70% with PW20 > 95% is suggested. The Mercy method, the PAWPER tape and parental estimates were the most accurate weight estimation systems followed by length-based and age-based systems. The use of age-based formulas should be abandoned because of their poor accuracy.
Electronic supplementary material
The online version of this article (10.1186/s12245-017-0156-5) contains supplementary material, which is available to authorized users.
