Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA.
Department of Nutrition, Institute for Global Nutrition, University of California, Davis, CA, USA.
Br J Nutr. 2023 May 28;129(10):1751-1764. doi: 10.1017/S0007114522001507. Epub 2022 May 19.
Technology-enabled approaches to conducting 24-h dietary recalls (24HR) may reduce dietary assessment bottlenecks in low-resource settings. However, few studies have assessed their performance relative to conventional pen-and-paper interview (PAPI) approaches and none have validated performance against a benchmark (e.g. weighed food record (WFR)) in a low- and middle-income country (LMIC). This study assessed relative accuracy and cost-effectiveness of INDDEX24, a technology-enabled approach to conducting 24HR, compared with a PAPI approach and against an observer WFR. Women aged 18-49 years from northern Viet Nam ( 234) were randomly assigned to be interviewed using INDDEX24 or PAPI 24HR following a WFR. The two one-sided test approach assessed the equivalence of each recall modality to the benchmark. Difference-in-differences analysis compared the recall-benchmark results across modalities. Cost per percentage point of accuracy for INDDEX24 and PAPI was derived from accuracy results and the cost to conduct the 24HR. The PAPI and INDDEX24 24HR were statistically equivalent to the WFR for all nutrients except vitamin A. INDDEX24 diverged significantly less than PAPI from the WFR for Fe (0·9 -1·3 mg) and PAPI diverged less for protein (-3·7 7·9 g). At the individual level, 26 % of PAPI and 32 % of INDDEX24 respondents had energy intakes within +/- 10 % of the WFR. INDDEX24 cost $111 004 and the PAPI cost $120 483 (USD 2019), making INDDEX24 more cost-effective across most indicators. INDDEX24 was an accurate and cost-effective method for assessing dietary intake in the study context and represents a preferred alternative to PAPI 24HR in Viet Nam and other LMIC.
技术辅助的 24 小时膳食回顾（24HR）方法可能会减少资源匮乏环境下饮食评估的瓶颈。然而，很少有研究评估其相对于传统纸笔访谈（PAPI）方法的性能，也没有在中低收入国家（LMIC）中针对基准（例如称重食物记录（WFR））验证性能。本研究评估了 INDDEX24 作为一种技术辅助的 24HR 方法与 PAPI 方法相比的相对准确性和成本效益，并与观察者 WFR 进行了比较。越南北部年龄在 18-49 岁的女性（234 人）在 WFR 后随机分配接受 INDDEX24 或 PAPI 24HR 访谈。两种单边检验方法评估了每种回忆方式与基准的等效性。模式之间的差异分析比较了回忆基准的结果。从准确性结果和进行 24HR 的成本中得出了 INDDEX24 和 PAPI 的每百分点准确性成本。PAPI 和 INDDEX24 24HR 在除维生素 A 以外的所有营养素方面与 WFR 统计上等效。INDDEX24 与 WFR 的差异明显小于 PAPI 对于铁（0·9-1·3mg）和 PAPI 对于蛋白质的差异较小（-3·7-7·9g）。在个人层面上，26%的 PAPI 和 32%的 INDDEX24 受访者的能量摄入量与 WFR 相差±10%以内。INDDEX24 的成本为 111,004 美元，而 PAPI 的成本为 120,483 美元（2019 年美元），在大多数指标上，INDDEX24 更具成本效益。INDDEX24 是一种在研究背景下评估饮食摄入的准确且具有成本效益的方法，它代表了越南和其他 LMIC 中 PAPI 24HR 的首选替代方法。
