Are “virtual” paediatric weight estimation studies valid?
“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 o...
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Published in | African Journal of Emergency Medicine Vol. 9; no. 1; pp. 36 - 40 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Netherlands
Elsevier B.V
01.03.2019
African Federation for Emergency Medicine Elsevier |
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Abstract | “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.
Virtual 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.
The 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.
The 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. |
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AbstractList | 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. Methods: Virtual 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. Results: The 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. Conclusions: The 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. Keywords: Broselow tape, PAWPER tape, Paediatric weight estimation "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. Virtual 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. The 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. The 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. 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. |
Author | Goldstein, Lara Wells, Mike |
AuthorAffiliation | Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa |
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CitedBy_id | crossref_primary_10_1002_emp2_12515 crossref_primary_10_7759_cureus_29278 crossref_primary_10_1136_emermed_2020_209581 crossref_primary_10_1002_emp2_12255 crossref_primary_10_2298_MPNS2108232B |
Cites_doi | 10.1016/j.annemergmed.2016.02.043 10.1097/PEC.0000000000001212 10.1136/adc.2011.212563.3 10.2174/1875181401204010087 10.1016/j.resuscitation.2012.05.028 10.7196/SAMJ.2016.v106i9.10572 10.1016/j.afjem.2017.12.003 10.1016/j.resuscitation.2017.05.018 10.1197/j.aem.2006.12.014 10.1097/PEC.0000000000000543 10.7196/SAMJ.2017.v107i11.12505 10.1097/PEC.0000000000001277 10.1016/j.resuscitation.2017.09.026 10.1136/archdischild-2018-315840 10.3109/10903127.2012.664247 |
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References | Wells, Goldstein, Bentley (b0020) 2018; 8 Young, Korotzer (b0005) 2016; 68 Technical report on WHO child growth standards-length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age – methods and development 2006 [accessed 9.11.2018]. Available from Marlow, Lo, Walton (b0065) 2011; 96 Murugan, Parris, Wells (b0055) 2018 Georgoulas, Wells (b0035) 2016; 106 Wells, Goldstein, Bentley, Basnett, Monteith (b0045) 2017; 121 . Marlow, Wood, Lyttle (b0025) 2018 Wells, Goldstein, Bentley (b0040) 2017; 2 Both, Schmitz, Buehler, Weiss, Schmidt (b0075) 2017 Abdel-Rahman, Ridge (b0080) 2012; 4 Abdel-Rahman, Jacobsen, Watts, Doyle, O'Malley, Hefner (b0015) 2017; 33 Wells, Coovadia, Kramer, Goldstein (b0030) 2013; 84 Jang, Shin, Kwak (b0070) 2007; 14 Heyming, Bosson, Kurobe, Kaji, Gausche-Hill (b0090) 2012; 16 Wells, Goldstein, Bentley (b0095) 2017; 116 Wells, Goldstein, Bentley (b0010) 2017; 10 Hirata, Kang, Ramirez, Kimata, Yamamoto (b0050) 2017 Wells, Goldstein, Bentley (b0085) 2017; 107 Wells (10.1016/j.afjem.2019.01.008_b0030) 2013; 84 Both (10.1016/j.afjem.2019.01.008_b0075) 2017 Marlow (10.1016/j.afjem.2019.01.008_b0065) 2011; 96 Abdel-Rahman (10.1016/j.afjem.2019.01.008_b0015) 2017; 33 Heyming (10.1016/j.afjem.2019.01.008_b0090) 2012; 16 Wells (10.1016/j.afjem.2019.01.008_b0020) 2018; 8 Murugan (10.1016/j.afjem.2019.01.008_b0055) 2018 Young (10.1016/j.afjem.2019.01.008_b0005) 2016; 68 Wells (10.1016/j.afjem.2019.01.008_b0040) 2017; 2 10.1016/j.afjem.2019.01.008_b0060 Abdel-Rahman (10.1016/j.afjem.2019.01.008_b0080) 2012; 4 Wells (10.1016/j.afjem.2019.01.008_b0010) 2017; 10 Marlow (10.1016/j.afjem.2019.01.008_b0025) 2018 Georgoulas (10.1016/j.afjem.2019.01.008_b0035) 2016; 106 Wells (10.1016/j.afjem.2019.01.008_b0045) 2017; 121 Wells (10.1016/j.afjem.2019.01.008_b0085) 2017; 107 Jang (10.1016/j.afjem.2019.01.008_b0070) 2007; 14 Wells (10.1016/j.afjem.2019.01.008_b0095) 2017; 116 Hirata (10.1016/j.afjem.2019.01.008_b0050) 2017 |
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A comparison of 4 emergency tapes with different length-based weight categorization publication-title: Pediatr Emerg Care doi: 10.1097/PEC.0000000000001212 contributor: fullname: Both – volume: 96 start-page: A1 issue: Suppl. 1 year: 2011 ident: 10.1016/j.afjem.2019.01.008_b0065 article-title: Accurate paediatric weight estimation by age: mission impossible? publication-title: Arch Dis Child doi: 10.1136/adc.2011.212563.3 contributor: fullname: Marlow – volume: 4 start-page: 87 year: 2012 ident: 10.1016/j.afjem.2019.01.008_b0080 article-title: An improved pediatric weight estimation strategy publication-title: Open Med Dev J doi: 10.2174/1875181401204010087 contributor: fullname: Abdel-Rahman – volume: 84 start-page: 227 issue: 2 year: 2013 ident: 10.1016/j.afjem.2019.01.008_b0030 article-title: The PAWPER tape: a new concept tape-based device that increases the accuracy of weight estimation in children through the inclusion of a modifier based on body habitus publication-title: Resuscitation doi: 10.1016/j.resuscitation.2012.05.028 contributor: fullname: Wells – volume: 106 start-page: 933 issue: 9 year: 2016 ident: 10.1016/j.afjem.2019.01.008_b0035 article-title: The PAWPER tape and the Mercy Method outperform other methods of weight estimation in children in South Africa publication-title: S Afr Med J doi: 10.7196/SAMJ.2016.v106i9.10572 contributor: fullname: Georgoulas – volume: 8 start-page: 43 issue: 2 year: 2018 ident: 10.1016/j.afjem.2019.01.008_b0020 article-title: The accuracy of paediatric weight estimation during simulated emergencies: the effects of patient position, patient cooperation and human errors publication-title: Afr J Emerg Med doi: 10.1016/j.afjem.2017.12.003 contributor: fullname: Wells – volume: 116 start-page: 73 issue: 7 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0095 article-title: It is time to abandon age-based emergency weight estimation in children! A failed validation of 20 different age-based formulas publication-title: Resuscitation doi: 10.1016/j.resuscitation.2017.05.018 contributor: fullname: Wells – volume: 14 start-page: 489 issue: 5 year: 2007 ident: 10.1016/j.afjem.2019.01.008_b0070 article-title: Can the Broselow tape be used to estimate weight and endotracheal tube size in Korean children? publication-title: Acad Emerg Med doi: 10.1197/j.aem.2006.12.014 contributor: fullname: Jang – volume: 33 start-page: 548 issue: 8 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0015 article-title: Comparative performance of pediatric weight estimation techniques: a human factor errors analysis publication-title: Pediatr Emerg Care doi: 10.1097/PEC.0000000000000543 contributor: fullname: Abdel-Rahman – volume: 107 start-page: 1015 issue: 11 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0085 article-title: Development and validation of a method to estimate bodyweight in critically ill children using length and mid-arm circumference measurements – the PAWPER XL-MAC system publication-title: S Afr Med J doi: 10.7196/SAMJ.2017.v107i11.12505 contributor: fullname: Wells – year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0050 article-title: Pediatric weight errors and resultant medication dosing errors in the Emergency Department publication-title: Pediatr Emerg Care doi: 10.1097/PEC.0000000000001277 contributor: fullname: Hirata – volume: 121 start-page: 9 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0045 article-title: The accuracy of the Broselow tape as a weight estimation tool and a drug-dosing guide – a systematic review and meta-analysis publication-title: Resuscitation doi: 10.1016/j.resuscitation.2017.09.026 contributor: fullname: Wells – year: 2018 ident: 10.1016/j.afjem.2019.01.008_b0055 article-title: Drug preparation and administration errors during simulated paediatric resuscitations publication-title: Arch Dis Child doi: 10.1136/archdischild-2018-315840 contributor: fullname: Murugan – volume: 10 start-page: 1 issue: 29 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0010 article-title: The accuracy of emergency weight estimation systems in children – a systematic review and meta-analysis publication-title: Int J Emerg Med contributor: fullname: Wells – ident: 10.1016/j.afjem.2019.01.008_b0060 – volume: 16 start-page: 374 issue: 3 year: 2012 ident: 10.1016/j.afjem.2019.01.008_b0090 article-title: Accuracy of paramedic Broselow tape use in the prehospital setting publication-title: Prehospital Emerg Care doi: 10.3109/10903127.2012.664247 contributor: fullname: Heyming – volume: 2 start-page: 1 issue: 4 year: 2017 ident: 10.1016/j.afjem.2019.01.008_b0040 article-title: A validation study of the PAWPER XL tape: accurate estimation of both total and ideal body weight in children up to 16 years of age publication-title: Trauma Emerg Care contributor: fullname: Wells – year: 2018 ident: 10.1016/j.afjem.2019.01.008_b0025 article-title: Comparing the usability of paediatric weight estimation methods: a simulation study publication-title: Arch Dis Child contributor: fullname: Marlow |
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