Children were recruited from nine primary care pediatricians or family practice clinics in Toronto, Canada between 20. TARGet Kids! is a primary care practice based research network ( ). Children were recruited from scheduled well-child primary care visits through TARGet Kids!. The objective of this study was to evaluate the degree of misclassification resulting from the use of cut-points defined by rounded percentiles relative to Z-scores for growth monitoring in early childhood.Ī cross-sectional study was conducted among children 0–5 years. This may be important when comparing differences between studies that have unintentionally used slightly different cut-points. However, the use of cut-points defined by rounded percentiles instead of exact z-scores may result in misclassification of children’s growth status, yet to the best of our knowledge, the magnitude of this misclassification has not been evaluated. Z-scores have been recommended for research, and percentiles for clinical settings as they may be easier to understand. These rounded percentiles correspond to exact Z-scores of − 1.88, 1.04, 1.88 and 3.09, in comparison to the WHO recommended cut-points of − 2.0, 1.0, 2.0 and 3.0, respectively. Rounded percentiles of the 3rd, 85th, 97th and 99.9th are commonly used in clinical practice and recommended for monitoring child growth in Canada. Z-scores can be converted directly to percentiles, although when converted the percentiles are often rounded. In contrast, percentiles rank a child’s position in comparison to a reference population. Z-scores are on a linear scale, with the same interval between values across the distribution this allows for calculation of the mean and standard deviation. Several advantages of the Z-score for population-based assessment of child growth have been described. For example, body mass index (BMI)-for-age Z-score cut-points of 1.0, > 2.0 and > 3.0 are recommended by the WHO to classify children 0–5 years of age as wasted, risk-of-overweight, overweight, and obese, respectively. Z-scores, or standard deviation scores, describe where an observation falls within a number of standard deviations of the mean. The WHO Child Growth Standards provide child growth measures standardized by age and sex using Z-scores. These cut-points for age and sex standardized growth measures are defined using either Z-scores or percentiles. Regardless of which reference standard is used, cut-point definitions are required for clinicians and researchers to classify children’s growth status. The WHO Growth Standards were developed following children from 6 countries under optimal growth conditions. The World Health Organization (WHO) Child Growth Standards charts are recommended as a reference standard for the growth monitoring of children 0–5 years of age and have been endorsed by many countries. Monitoring of child growth, including classification of both underweight and overweight categories, is important for population health, and routine child growth monitoring is recommended. Misclassification of child growth results from the use of cut-points defined by rounded percentiles instead of Z-scores and limits comparability between studies. Overall, 117 (2%) children were misclassified when using percentiles instead of Z-scores however, 13% (33/245) of children who were wasted and 14% (8/57) of children who were obese were misclassified. Using rounded percentiles, the proportion of children who were wasted, at risk of overweight, overweight, and obese was 4.2, 12.5, 4.3 and 0.8%, whereas the distribution using Z-scores was: 3.6, 13.8, 3.4 and 1.0%, respectively. Misclassification was calculated comparing the frequency distributions for BMI categories defined by rounded percentiles and Z-score cut-points. However, rounded percentiles of the 3rd, 85th, 97th, and 99.9th are commonly used. Using data from the TARGet Kids primary care network we conducted a cross-sectional study among 5836 children 1.0, > 2.0, > 3.0 are recommended to define wasted, at risk of overweight, overweight and obese. To evaluate the misclassification resulting from the use of body mass index (BMI) cut-points defined by rounded percentiles instead of Z-scores in early childhood.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |