Nutrition Research Division, Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia.
J Am Coll Nutr. 2011 Dec;30(6):522-8. doi: 10.1080/07315724.2011.10719998.
To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year.
A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software.
The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference.
The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.
研究视觉临床评估体重与身长以及身长与年龄的有效性，与世界卫生组织（WHO）2006 标准和国家健康统计中心（NCHS）1977 参考标准相比，评估 1 岁以下儿童的体格生长。
在马来西亚 2 个州的政府诊所进行了一项前瞻性队列研究。684 名婴儿在 9 次就诊中同一天测量体重、身长和临床评估，从 6 个月前每月一次，到 12 个月前每两个月一次。所有 3 个体重与年龄（WAZ）、身长与年龄（HAZ）和体重与身长（WHZ）的 z 分数均使用 WHO Anthro for Personal Computers 软件计算。
使用 WHO 2006 标准进行视觉临床评估时，消瘦的平均灵敏度和特异性高于使用 NCHS 1977 标准。然而，从 1 个月到 1 岁，视觉临床评估对消瘦和瘦弱儿童的总体敏感性低于 WHO 2006 标准和 NCHS 1977 参考。与 NCHS 1977 参考相比，视觉临床评估与 WHO 2006 标准的阳性预测值（PPV）几乎翻了一番。视觉临床评估与 WHO 2006 标准相比，总体平均灵敏度、特异性、PPV 和阴性预测值均较高，用于检测生长迟缓。
与 NCHS 1977 参考相比，视觉临床评估对婴儿消瘦和生长迟缓的检测灵敏度和特异性更好，适用于 WHO 2006 标准。
