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    Use and interpretation of pediatric anthropometry in epidemiologic studies.

    Sullivan K; Gorstein J; Trowbridge F; Yip R

    [Unpublished] 1991. Presented at the Society for Epidemiologic Research 24th Annual Meeting, Buffalo, New York, June 11-14, 1991. 12, [18] p.

    Health workers use anthropometry to determine the nutritional status of children. The accepted international growth reference curves provide the bases for the indices which include weight for height (W/H), height for age (H/A) and weight for age (W/A). Health workers must interpret these indices with caution, however. For example, W/H and H/A represent different physiological and biological processes while W/A combines the 2 processes. Further Z-scores, percentiles, or percent of median may be used as the scale for the indices and each scale has different statistical features. Specifically, Z-scores and percentiles acknowledge smoothed normalized distributions around the median, but the percent-of-median ignores the distribution around the median. Some researchers suggest using Z-scores rather than percentiles or percent-of-median since statisticians can interpret them more clearly and can calculate the proportion of children in the reference population who fall above or below a cut off point more easily. This cutoff should be only used to screen children who are likely to be malnourished since not all children below a cutoff are indeed malnourished. Some researchers have identified a leading limitation of the CDC/WHO based indices. A disjunction exists where the 2 smoothed based curves based on a population of <36 month old children from Ohio (longitudinal data) and another population of 2-18 year old children (cross sectional health surveys) meet. Further there is a reduction in age specific prevalences at 24 months. Thus some researchers recommend that anthropometry data be presented on an age specific basis, if age information is accurate. They further suggest that, if comparing data from different geographic areas, researchers should standardize age to have a summary measure. If age is not known the W/H summary measure should include 2 groups: <85 cm and =or+ 85 cm.
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