Rifas-Shiman Sheryl L, Rich-Edwards Janet W, Scanlon Kelley S, Kleinman Ken P, Gillman Matthew W
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA.
MedGenMed. 2005 Nov 29;7(4):56.
Accurate determination of the length of very young children is important because weight-for-length standards are used to assess both under- and overweight. Clinical measurements of length, which usually involve a paper-and-pencil method, may often be inaccurate in children younger than 2 years.
To compare length measured by the conventional clinical paper-and-pencil method with length measured by the research standard recumbent length-board method in a sample of children under 2 years of age.
Research assistants measured 160 children 0 through 23 months of age using the recumbent length-board method, and clinical staff measured the same children using the paper-and-pencil method. To assess the relationship between the research and clinical length measurements, we used ordinary least squares regression.
We found a strong linear relationship between the 2 measures of length (R2 = 0.98). The paper-and-pencil method systematically overestimated length in children under 2 years of age. A fitted regression equation estimated that the research standard length was 95.3% of the clinical measurement plus 1.88 cm. Over the entire age span, the mean (SD) difference between clinical and research measurements was 1.3 (1.5) cm.
Using the paper-and-pencil method can lead to underestimates of overweight and exaggerated estimates of thinness. To improve the accuracy of length measurement, medical providers should use standardized procedures with a recumbent length board to measure children under 2 years of age, at least for children whose initial paper-and-pencil measurement of length puts them at one extreme or the other.
准确测定幼儿的身长很重要，因为身长别体重标准用于评估体重过轻和超重情况。身长的临床测量通常采用纸笔测量法，对于2岁以下儿童，这种方法往往不准确。
比较传统临床纸笔测量法与研究标准卧式身长板测量法在2岁以下儿童样本中的测量结果。
研究助理使用卧式身长板测量法对160名0至23个月大的儿童进行测量，临床工作人员使用纸笔测量法对这些儿童进行测量。为评估研究测量值与临床测量值之间的关系，我们采用了普通最小二乘法回归。
我们发现两种身长测量方法之间存在很强的线性关系（R2 = 0.98）。纸笔测量法系统性地高估了2岁以下儿童的身长。拟合回归方程估计，研究标准身长为临床测量值的95.3%加上1.88厘米。在整个年龄范围内，临床测量值与研究测量值之间的平均（标准差）差异为1.3（1.5）厘米。
使用纸笔测量法可能会低估超重情况并高估消瘦情况。为提高身长测量的准确性，医疗服务提供者应使用标准化程序，采用卧式身长板对2岁以下儿童进行测量，至少对于那些最初纸笔测量的身长值处于极端情况的儿童应如此。
