Yordanov Stefan, Akhter Kalsoom, Quan Teh Jye, Naushahi Jawad, Jalloh Ibrahim
Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom.
JMIR Form Res. 2024 Feb 14;8:e54194. doi: 10.2196/54194.
Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to errors, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner techniques, including tape measure placement and tautness. There is, therefore, the need for a more reliable method.
The primary objective of this study was to evaluate the validity, reliability, and consistency of HC app measurement compared to the current standard of practice, serving as a proof-of-concept for use by health care professionals.
We recruited infants attending the neurosurgery clinic, and parents/guardians were approached and consented to participate in the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app (HC app) developed in-house, and we also collected baseline medical history and characteristics. For the statistical analysis, we used RStudio (version 4.1.1). In summary, we analyzed covariance and intraclass correlation coefficient (ICC) to compare the measurement's within-rater and interrater reliability. The F test was used to analyze the variance between measurements and the Bland-Altman agreement, t test, and correlation coefficients were used to compare the tape measurement to the measures taken by the HC app. We also used nonvalidated questionnaires to explore parental or guardians' experiences, assess their views on app utility, and collect feedback.
The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability (ICC=0.177) and wide within-app variations (ICC=0.341). The agreement between the measurements done by parents/guardians and the tape measurements done by the researcher was good (ICC=0.901). Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (n=31, 84%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality.
We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by parents/guardians in their own homes.
在评估新生儿和婴儿时，准确测量头围（HC）至关重要。使用卷尺测量头围容易出错，尤其是由父母/监护人进行测量时，这是由于头型、发型和发质的个体差异、受试者的配合程度以及检查者的技术，包括卷尺的放置和拉紧程度等因素导致的。因此，需要一种更可靠的方法。
本研究的主要目的是评估头围应用程序测量与当前标准做法相比的有效性、可靠性和一致性，为医疗保健专业人员提供概念验证。
我们招募了到神经外科门诊就诊的婴儿，并与父母/监护人进行沟通，征得他们同意参与研究。除了进行标准头围测量外，还使用内部开发的头围应用程序（HC应用程序）进行测量，我们还收集了基线病史和特征。对于统计分析，我们使用了RStudio（版本4.1.1）。简而言之，我们分析了协方差和组内相关系数（ICC），以比较测量的评分者内和评分者间可靠性。使用F检验分析测量之间的方差以及Bland-Altman一致性，使用t检验和相关系数比较卷尺测量与HC应用程序测量的结果。我们还使用未经验证的问卷来探索父母或监护人的体验，评估他们对应用程序实用性的看法，并收集反馈。
招募的患者总数为37名。应用程序测量与卷尺测量之间的比较显示可靠性较差（ICC = 0.177），且应用程序内的差异较大（ICC = 0.341）。父母/监护人进行的测量与研究人员进行的卷尺测量之间的一致性良好（ICC = 0.901）。父母/监护人的反馈总体非常积极，大多数父母/监护人表示该应用程序易于使用（n = 31，84%），并且如果他们对测量质量有信心，他们愿意在无人监督的情况下使用该应用程序。
我们将该项目作为一项概念验证研究开展，因此，该应用程序在临床环境以及父母/监护人在家中使用方面都显示出了巨大的潜力。
