The Accuracy of the Broselow™ Pediatric Emergency Tape for Weight Estimation in an Omani Paediatric Population.
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ABSTRACT:
SUBMITTER: Al-Busaidi AA
PROVIDER: S-EPMC5488820 | biostudies-other | 2017 May
REPOSITORIES: biostudies-other
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Project description:To determine the accuracy of the Broselow tape on estimating body weights of selected Saudi children. Methods: This is prospective study of children aged 7 days to 13 years who attended the Emergency Department of King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Saudi Arabia, from June 2015 to September 2015. Only children less than 34 kg were enrolled for the study and children with triage categories I and II were eliminated to avoid delay in providing appropriate treatment in these circumstances. Results: The relationship between the actual and tape estimated body weights showed a correlation coefficient of 0.945 (p less than 0.001) for all children. When adjusting the correlation coefficient related to weight groups, the correlation coefficient was 0.911 (p less than 0.001) for children with body weights between 10 to 25 kg. Conclusion: The Broselow tape measurements do not provide satisfactory results for all children in the selected population, but do provide highly correlated measurements for those children with body weights between 10 and 25 kg.
| S-EPMC5556295 | biostudies-other
Project description:Study objectiveWe assessed the performance of 2 new devices (2D- and 3D-Mercy TAPE) to implement the Mercy Method for pediatric weight estimation and contrasted their accuracy with the Broselow method.MethodsWe enrolled children aged 2 months through 16 years in this prospective, multicenter, observational study. Height/length, weight, humeral length, and mid-upper arm circumference were obtained for each child, using calibrated scales and measures. We then made measurements with blinded versions of the 2D- and 3D-TAPEs. Using height/length data, we calculated the weight estimated by the Broselow method. We contrasted measures with mean error, mean percentage error, and percentage predicted within 10% and 20% of actual.ResultsSix hundred twenty-four participants (median 8.5 years, 27.6 kg, 17.3 kg/m(2)) completed the study. Mean error was 0.3 kg (mean percentage error 1.6%), 0.2 kg (mean percentage error 1.9%), and -1.3 kg (mean percentage error -4.1%) for 2D-, 3D-, and Broselow, respectively. Concordance between both TAPE devices and the Mercy Method was greater than 0.99. The proportion of children predicted within 10% and 20% of actual weight was 76% and 98% for the 2D-TAPE and 65% and 93% for the 3D-TAPE. Excluding the 209 (33%) children who were too tall for the device, Broselow predictions were within 10% and 20% of actual weight in 59% and 91%.ConclusionThe 2D- and 3D-Mercy TAPEs outperform the Broselow tape for pediatric weight estimation and can be used in a wider range of children.
| S-EPMC4039210 | biostudies-literature
Project description:BACKGROUND:Children with emergency conditions require immediate life-saving intervention and resuscitation. Unlike adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child. Broselow tape is a color-coded length-based tape that utilizes height/weight correlations for children. However, in low-income countries like Nepal, due to factors like undernutrition, the Broselow tape may not accurately estimate weight in all ranges of pediatric age group. METHODS:This study was conducted in the Department of Pediatrics of Dhulikhel Hospital, Kathmandu University Teaching Hospital, in children less than 15?years of age. Our study aims to prospectively compare the actual weights of urban and rural Nepalese children with the estimated weights using the Broselow tape (2017 edition) and the updated APLS formula. The errors in the selection of endotracheal tube size and adrenaline dose using the Broselow tape were also explored. RESULTS:This study included 315 children with male to female ratio of 0.63:1. They were divided into 3 groups according to their estimated weight by the Broselow tape into <?10?kg, 10-18, and >?18?kg. There was a total agreement of the estimated color zone according to the Broselow tape with the actual weight in the gray zone (p?=?0.01). There was a positive relationship between the actual body weight and the estimated body weight (correlation (r?=?0.970, p?=?0.01) and accuracy (r2?=?0.941)). Our analysis showed that the accuracy of estimated weight with the Broselow tape decreases with increasing weight of children. The precision of the tape was relatively high in the lower length zones as compared to the higher length zones. The estimated size of the endotracheal tube (p?=?0.01) and adrenaline dose (p?=?0.08) by the Broselow tape was in agreement with that estimated using PALS formula in weight group of less than 18?kg, but decreases as the estimated weight increases further. CONCLUSIONS:The accuracy of the Broselow tape in estimating the weight of a child, endotracheal tube size, and dose of adrenaline is higher in weight group of less than 18?kg, and accuracy decreases as the weight of child increases. The Broselow tape should be avoided in children weighing more than 18?kg. Hence, PALS age-based formula for ET tube size estimation and weight-based formula for adrenaline dose calculation are recommended for children weighing more than 18?kg.
| S-EPMC7017533 | biostudies-literature
Project description:IntroductionWhen weight cannot be measured during the management of medical emergencies in children, a convenient, quick and accurate method of weight estimation is required, as many drug doses and other interventions are based on body weight. Many weight estimation methodologies in current use have been shown to be inaccurate, especially in low- and middle-income countries with a high prevalence of underweight children. This meta-analysis evaluated the accuracy of weight estimation systems in children from studies from low- and middle-income countries.MethodsArticles from low- and middle-income countries were screened for inclusion to evaluate and compare the accuracy of existing systems and the newer dual length- and habitus-based methods, using standard meta-analysis techniques.ResultsThe 2D systems and parental estimates performed best overall. The PAWPER tape, parental estimates, the Wozniak method and the Mercy method were the most accurate systems with percentage of weight estimates within 10% of actual weight (PW10) accuracies of 86.9%, 80.4%, 72.1% and 71.4% respectively. The Broselow tape (PW10 47.1%) achieved a moderate accuracy and age-based estimates a very low accuracy (PW10 11.8-47.5%).ConclusionsThe PAWPER tape, the Wozniak method and the Mercy method achieved an acceptable level of accuracy in studies from low- and middle-income countries and should preferentially be used and further advanced for clinical emergency medicine practice. Parental estimates may be considered if the regular caregiver of the child is present and a recent measured weight is known. The Broselow tape and age-based formulas should be abandoned in low- and middle-income country populations as they are potentially dangerously inaccurate.
| S-EPMC6246873 | biostudies-literature
Project description:Introduction"Virtual" studies account for nearly one-third of all published weight estimation articles, but the validity of these virtual studies has never been evaluated. It is important to establish this validity in order to decide whether the results of these studies can be applied to real-world usage. The objectives of this study were to evaluate the accuracy of virtual weight estimates using the Broselow and PAWPER tapes and compare these to actual real-life estimates from the tapes.MethodsVirtual weights were generated for the Broselow and PAWPER tapes using anthropometric data from a sample of 1385 children for whom actual Broselow and PAWPER tape weights were available. The accuracy of the virtual and real-life estimates was compared against each child's actual weight. The agreement of the virtual and real estimates was also evaluated.ResultsThe percentage of weight estimates within 10% of actual weight were 57.9% and 59.3% for the real and virtual Broselow tapes respectively and 76.6% and 78.4% for the real and virtual PAWPER tapes respectively. The Cohen's kappa for the real and virtual Broselow and PAWPER tapes was 0.65 and 0.64 respectively, which indicated substantial agreement.ConclusionsThe virtual and real weight estimates had very similar accuracy outcomes for both tapes in this study. However, if virtual studies are used, they should be followed by real-life studies in order to assess the impact of human and patient factor errors on the accuracy of the weight estimation systems.
| S-EPMC6400007 | biostudies-literature
Project description: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.
| S-EPMC5608658 | biostudies-literature
Project description:IntroductionThe effect of patient position and patient cooperation on the accuracy of emergency weight estimation systems has not been evaluated previously. The objective of this study was to evaluate weight estimation accuracy of the Broselow tape, the PAWPER XL tape, the Mercy method, and a custom-designed mobile phone App in a variety of realistic simulated paediatric emergencies.MethodsThis was a prospective study in which 32 emergency medicine volunteers participated in eight simulations of common paediatric emergency conditions, using children models. The participants used each of the four methods to estimate the children's weight. The accuracy of and time taken for the weight estimations were evaluated for each method. A regression analysis determined the effects of patient position and cooperation on weight estimation accuracy. Evaluation of subgroups of best-performers and worst-performers among the participants provided information on the effects of human user-error on weight estimation accuracy.ResultsThe Broselow tape, Mercy method, App and the PAWPER XL tape achieved percentages of weight estimation within 10% of actual weight in 47.7, 57.3, 68.1, and 73.0% of estimations, respectively. Patient position and cooperation strongly impacted the accuracy of the Broselow tape, had a minimal effect on the Mercy method and the App, and had no effect on the PAWPER XL tape. The best performing participants achieved very high accuracy with all methods except the Broselow tape.DiscussionThe Mercy method, the App, and the PAWPER XL tape achieved exceptionally high accuracy even in uncooperative and sub-optimally positioned children when used by the best-performing participants. Human error, from inexperience and inadequate training, had the most significant impact on accuracy. The Mercy method was the most subject to human error, and the PAWPER XL tape, the least. Adequate training in using weight estimation systems is essential for paediatric patient safety.
| S-EPMC6223595 | biostudies-literature
Project description:IntroductionWeight estimation in children is critical in paediatric emergencies. The Broselow Tape (BT) and most age-based formulae for weight estimation were derived in high-income countries and are thought to overestimate the weight of children in low-income countries. This study sought to validate the 2017 BT, and eight age-based weight estimation formulae among Ghanaian children and to derive a weight estimation formula using this data.MethodsA cross-sectional study was conducted in the Tamale Teaching Hospital (TTH) in Ghana. Children aged between 2 months and 13 years had their weights estimated by the 2017 BT and eight age-based formulae. These estimated weights were compared to the weight of the children measured by a calibrated Seca scale using mean percentage error (MPE) and the percentage of weight estimates within 10% and 20% of actual weight. Bland-Altman method was used to assess agreement between estimated and actual weight of the children. A new formula was derived by linear regression.ResultsSeven hundred and seventy-five children took part in the study. The 2017 BT, Original APLS (APLS1) and Nelson's formulae performed best with proportion of weight estimates within 10% of actual weight being 47.5%, 51.1% and 47.5% respectively. The formula developed in this study was: WE = 3Am / 10 + 5 (for infants <12 months), WE = 2A + 7 (1 to 4 years) and WE = 2A + 9 (5 to 13 years), where WE is estimated weight, Am is age in completed months and A is age in completed years. The new formula had similar accuracy as the three best performing methods in this study.ConclusionThe Broselow Tape, APLS1 and the Nelson's formula were the most accurate in this study. APLS1 and the Broselow Tape can be used for weight estimation in Ghanaian children when no other better method is available.
| S-EPMC8027529 | biostudies-literature
Project description:IntroductionThe choice of weight estimation method to use during prehospital paediatric emergency care is important because it needs to be both accurate and easy to use. Accuracy is important to ensure optimum drug dosing while ease-of-use is important to minimise user errors and the cognitive load experienced by healthcare providers. Little is known about which weight estimation systems are used in the prehospital environment anywhere in the world. This knowledge is important because if the use of inappropriate weight estimation practices is identified, it could be remedied through education and institutional policies.MethodsThis was a prospective questionnaire study conducted in Johannesburg, South Africa, which obtained information on the knowledge, attitude and practice of weight estimation amongst advanced life support (ALS) paramedics.ResultsForty participants were enrolled, from both the public and private sectors. The participants' preferred method of weight estimation was visual estimation (7/40; 18%), age-based formulas (16/40; 40%), parental estimation (3/40; 8%), the Broselow tape (2/40; 5%) and the PAWPER tape (11/40; 28%). No participant was familiar with or used the Mercy method. All participants were very confident in the accuracy of their selected system.DiscussionThe knowledge and understanding of weight estimation systems by many advanced life support paramedics was poor and the use of inappropriate weight estimation systems was common. Further education and intervention is needed in order to change the sub-optimal weight estimation practices of ALS paramedics in Johannesburg.
| S-EPMC6223602 | biostudies-literature
Project description:Software development effort estimation (SDEE) is recognized as vital activity for effective project management since under or over estimating can lead to unsuccessful utilization of project resources. Machine learning (ML) algorithms are largely contributing in SDEE domain, particularly ensemble effort estimation (EEE) works well in rectifying bias and subjectivity to solo ML learners. Performance of EEE significantly depends on hyperparameter composition as well as weight assignment mechanism of solo learners. However, in EEE domain, impact of optimization in terms of hyperparameter tunning as well as weight assignment is explored by few researchers. This study aims in improving SDEE performance by incorporating metaheuristic hyperparameter and weight optimization in EEE, which enables accuracy and diversity to the ensemble model. The study proposed Metaheuristic-optimized Multi-dimensional bagging scheme and Weighted Ensemble (MoMdbWE) approach. This is achieved by proposed search space division and hyperparameter optimization method named as Multi-dimensional bagging (Mdb). Metaheuristic algorithm considered for this work is Firefly algorithm (FFA), to get best hyperparameters of three base ML algorithms (Random Forest, Support vector machine and Deep Neural network) since FFA has shown promising results of fitness in terms of MAE. Further enhancement in performance is achieved by incorporating FFA-based weight optimization to construct Metaheuristic-optimized weighted ensemble (MoWE) of individual multi-dimensional bagging schemes. Proposed scheme is implemented on eight frequently utilized effort estimation datasets and results are evaluated by 5 error metrices (MAE, RMSE, MMRE, MdMRE, Pred), standard accuracy and effect size along with Wilcox statistical test. Findings confirmed that the use of FFA optimization for hyperparameter (with search space sub-division) and for ensemble weights, has significantly enhanced performance in comparison with individual base algorithms as well as other homogeneous and heterogenous EEE techniques.
| S-EPMC10994292 | biostudies-literature