The accuracy of Broselow pediatric emergency tape in estimating body weight of pediatric patients.
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ABSTRACT:
SUBMITTER: ALSulaibikh AH
PROVIDER: S-EPMC5556295 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:This study aimed to evaluate the accuracy of the Broselow™ Pediatric Emergency Tape (BT) for estimating weight in an Omani paediatric population at a tertiary care hospital.This retrospective cross-sectional study was conducted during July 2015. The electronic medical records of Omani outpatients <14 years old attending the Sultan Qaboos University Hospital, Muscat, Oman, between July 2009 and June 2013 were reviewed for recorded height and weight data. The BT Version 2002A was used to predict weight based on actual height measurements. Predicted weight measurements were then compared with actual weight to determine the accuracy of the estimation.A total of 3,339 children were included in the study, of which 43.5% were female and 56.5% were male. The mean age was 6.4 ± 3.1 years and the mean height was 93.2 ± 23.5 cm. The mean actual weight was 13.9 ± 6.7 kg while the mean BT-predicted weight was 14.4 ± 6.9 kg. The BT-predicted weight estimations correlated significantly with actual weight measurements (intraclass correlation coefficient: 0.97; P <0.001). A Bland-Altman analysis indicated that the BT performed well when estimating weight among Omani children, with an overestimation of only 0.5 kg for the entire cohort.The BT was found to be an effective tool for estimating weight according to body length in an Omani paediatric population. It should therefore be considered for use in emergency situations when actual weight cannot be determined.
| S-EPMC5488820 | biostudies-other
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:IntroductionMost drugs, fluids and ventilator settings depend on the weight of a paediatric patient. However, knowledge of the weight is often unavailable as the urgency of the situation may impede measurement. The most common methods for paediatric weight estimation are based on height or age. This study aimed to compare the accuracy of various weight estimation methods and to derive a dedicated age-based tool within a Rwandan setting.MethodsThis was a retrospective study using age, weight and height data from randomly selected charts of Rwandan children, aged between one and ten years, who attended the paediatric emergency centre, Centre Hospitalier Universitaire de Kigali, Rwanda. Weights were estimated using four versions of the Broselow Tape and several age-based formulae. Linear regression was used to derive a new age-based weight estimation formula, the Rwanda Rule. Weight estimations were then compared with actual weight using Bland-Altman analysis, and the proportions of estimates within 10 and 20% of actual weight.ResultsThere were 327 children included in the study. The derived Rwanda Rule was: weight (kg) = [1.7 × age (years)] + 8. This formula and the original Advanced Paediatric Life Support formula (weight = [2 × age] + 8) performed similarly. Both were better than other age-based formulae (69% of estimates within 20% of actual weight). All editions of the Broselow Tape performed better than age-based rules. The 1998 version performed best with 84.8% of estimates within 20% of actual weight.DiscussionThis study is the first to compare paediatric weight estimation methods in Rwanda. Locally, and until we have evidence from further research that other methods are superior, we would advise use of the 1998 Broselow Tape in children aged one to ten years old. Where the Broselow Tape is not available, the original Advanced Paediatric Life Support formula should be used.
| S-EPMC6223606 | biostudies-literature
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:The empirical scaling from adult to pediatric using allometric size adjustments based on body weight continued to be the mainstream method for pediatric dose selection. Due to the flexibility of a polynomial function to conform to the data trend, an empirical function for simulating age-matched weight and body mass index by gender in the pediatric population is developed by using a polynomial function and a constant coefficient to describe the interindividual variability in weight. A polynomial of up to fifth order sufficiently described the pediatric data from the Center for Disease Control (CDC) and the World Health Organization (WHO). The coefficients of variation to describe the variability were within 17%. The percentages of the CDC simulated weights for pediatrics between 0 and 5 years that fell outside the WHO 90% and 95% confidence boundaries were well within the expected percentage values, indicating that the CDC dataset can be used to substitute for the WHO dataset for the purpose of pediatric drug development. To illustrate the utility of this empirical function, the CDC-based age-matched weights were simulated and were used in the prediction of the concentration-time profiles of tenofovir in children based on a population pharmacokinetic model whose parameters were allometrically scaled. We have shown that the resulting 95% prediction interval of tenofovir in newborn to 5 years of age was almost identical whether the weights were simulated based on WHO or CDC dataset. The approach is simple and is broadly applicable in adjusting for pediatric dosages using allometry.
| S-EPMC4389747 | biostudies-literature
Project description:BackgroundSmart scales are increasingly used at home by patients to monitor their body weight and body composition, but scale accuracy has not often been documented.ObjectiveThe goal of the research was to determine the accuracy of 3 commercially available smart scales for weight and body composition compared with dual x-ray absorptiometry (DEXA) as the gold standard.MethodsWe designed a cross-sectional study in consecutive patients evaluated for DEXA in a physiology unit in a tertiary hospital in France. There were no exclusion criteria except patient declining to participate. Patients were weighed with one smart scale immediately after DEXA. Three scales were compared (scale 1: Body Partner [Téfal], scale 2: DietPack [Terraillon], and scale 3: Body Cardio [Nokia Withings]). We determined absolute error between the gold standard values obtained from DEXA and the smart scales for body mass, fat mass, and lean mass.ResultsThe sample for analysis included 53, 52, and 48 patients for each of the 3 tested smart scales, respectively. The median absolute error for body weight was 0.3 kg (interquartile range [IQR] -0.1, 0.7), 0 kg (IQR -0.4, 0.3), and 0.25 kg (IQR -0.10, 0.52), respectively. For fat mass, absolute errors were -2.2 kg (IQR -5.8, 1.3), -4.4 kg (IQR -6.6, 0), and -3.7 kg (IQR -8.0, 0.28), respectively. For muscular mass, absolute errors were -2.2 kg (IQR -5.8, 1.3), -4.4 kg (IQR -6.6, 0), and -3.65 kg (IQR -8.03, 0.28), respectively. Factors associated with fat mass measurement error were weight for scales 1 and 2 (P=.03 and P<.001, respectively), BMI for scales 1 and 2 (P=.034 and P<.001, respectively), body fat for scale 1 (P<.001), and muscular and bone mass for scale 2 (P<.001 for both). Factors associated with muscular mass error were weight and BMI for scale 1 (P<.001 and P=.004, respectively), body fat for scales 1 and 2 (P<.001 for both), and muscular and bone mass for scale 2 (P<.001 and P=.002, respectively).ConclusionsSmart scales are not accurate for body composition and should not replace DEXA in patient care.Trial registrationClinicalTrials.gov NCT03803098; https://clinicaltrials.gov/ct2/show/NCT03803098.
| S-EPMC8122302 | biostudies-literature
Project description:ImportanceFair allocation of livers between pediatric and adult recipients is critically dependent on the accuracy of mortality estimates afforded by the Pediatric End-stage Liver Disease (PELD) and Model for End-stage Liver Disease, respectively. Widespread reliance on exceptions for pediatric recipients suggests that the 2 systems may not be comparable.ObjectiveTo evaluate the accuracy of the PELD score in estimating 90-day pretransplant mortality among pediatric patients on the United Network for Organ Sharing (UNOS) waiting list.Design, setting, and participantsPatients who were listed from February 27, 2002, to March 31, 2014, for primary liver transplant were included in this retrospective analysis and were followed up for at least 2 years through June 17, 2016. The study analyzed 2 cohorts using the UNOS Standard Transplant Analysis and Research data files. The full cohort comprised 4298 patients (<18 years of age) who had chronic liver disease (excluding cancer). The reduced cohort (n = 2421) excluded patients receiving living donor transplantation or PELD exception points.Main outcomes and measuresObserved and expected 90-day pretransplant mortality rates evaluated at 10-point interval PELD levels.ResultsAmong the 4298 patients in the full cohort (mean [SD] age, 2.5 [4.2] years; 2251 [52.4%] female; 2201 [51.2%] white), PELD scores and mortality were concordant (C statistic, 0.8387 [95% CI, 0.8191-0.8584] for the full cohort and 0.8123 [95% CI, 0.7919-0.8327] for the reduced cohort). However, the estimated 90-day mortality using the PELD score underestimated the actual probability of death by as much as 17%.Conclusions and relevanceWith use of the PELD score, the ranking of risk among children was preserved, but direct comparisons between adult and pediatric candidates were not accurate. Children with chronic liver disease who are in need of transplant may be at a disadvantage compared with adults in a similar situation.
| S-EPMC6248160 | biostudies-literature
Project description:Microarrays revolutionized biological research by enabling gene expression comparisons on a transcriptome-wide scale. Microarrays, however, do not estimate absolute expression level accurately. At present, high throughput sequencing is emerging as an alternative methodology for transcriptome studies. Although free of many limitations imposed by microarray design, its potential to estimate absolute transcript levels is unknown. In this study, we evaluate relative accuracy of microarrays and transcriptome sequencing (RNA-Seq) using third methodology: proteomics. We find that RNA-Seq provides a better estimate of absolute expression levels. We first determined whether we could reproduce the agreement between mRNA expression estimates measured by microarrays and by RNA-Seq reported in other studies. For this purpose, we collected mRNA expression data in two independent cerebellar samples, each containing pooled mRNA from 5 adult human individuals, using both methodologies. Next, to test whether biological variation among samples would substantially reduce correlation strength, we compared expression levels determined by RNA-Seq in two pooled samples to the microarray data obtained from different individuals. For this purpose we used expression measurements obtained using Affymetrix Exon Arrays in 5 individual adult human cerebellar samples, none of which were included in the two pooled samples. Further, since technical and stochastic variation are extremely unlikely to result in better correlation between mRNA and protein expression measurements, we argue that the technology resulting in better correlation must provide more accurate measurements.
2010-04-08 | E-GEOD-13744 | biostudies-arrayexpress
Project description:Objective:The performance and interpretation of point-of-care ultrasound (POCUS) should be documented appropriately in the electronic medical record (EMR) with correct billing codes assigned. We aimed to improve complete POCUS documentation from 62% to 80% and improve correct POCUS billing codes to 95% or higher through the implementation of a quality improvement initiative. Methods:We collected POCUS documentation and billing data from the EMR. Interventions included: (1) staff education and feedback, (2) standardization of documentation and billing, and (3) changes to the EMR to support standardization. We used P charts to analyze our outcome measures between January 2017 and June 2018. Results:Six hundred medical records of billed POCUS examinations were included. Complete POCUS documentation rate rose from 62% to 91%, and correct CPT code selection for billing increased from 92% to 95% after our interventions. Conclusions:The creation of a standardized documentation template incorporated into the EMR improved complete documentation compliance.
| S-EPMC7375490 | biostudies-literature
Project description:This study aimed to identify associations among self-perceived weight status, accuracy of weight perceptions, and weight control behaviors, including both healthy and unhealthy behaviors, in a large, nationally representative sample from an East Asian country. Data were collected from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide survey. Accurate weight perceptions were investigated by comparing body mass index (BMI) categories, based on self-reported height and weight, and weight perceptions. Weight control behaviors over the previous 12 months were additionally surveyed. Odds ratios (ORs) and 95% confidence intervals (CIs) are presented as an index of associations. Among normal weight, overweight, and obese women, 12.8%, 44.3%, and 17.4% under-assessed their weight; 17.9% of normal weight women over-assessed their weight. Both weight status according to BMI category and weight perceptions were strongly associated with having tried to lose weight. Exercise and diet (ate less) were the most commonly applied weight control behaviors. Misperception of weight was related to more unhealthy weight control behaviors and less healthy behaviors: Women who under-assessed their weight showed a lower tendency to engage in dieting (OR?=?0.57, 95% CI?=?0.43-0.75) and a greater tendency to fast/skip meals (OR?=?1.47, 95% CI?=?1.07-1.99). Meanwhile, normal weight or overweight women who over-assessed their weight were more likely to have engaged in fasting/skipping meals or using diet pills (OR?=?5.72, 95% CI?=?2.45-13.56 for fasting/skipping meal in overweight women; OR?=?1.62, 95% CI?=?1.15-2.29 and OR?=?3.16, 95% CI?=?1.15-8.23 for using diet pills in normal and overweight women). Inaccuracy of weight perceptions in any direction (over/under) were related to more unhealthy weight control behaviors and less healthy weight control behaviors, especially in normal and overweight women.
| S-EPMC6591250 | biostudies-literature