Remote Assessment of Pediatric Anthropometrics.

Abstract

Objective: To assess the reliability and fidelity of caregiver- and examiner-administered anthropometric measurements in English- and Spanish-speaking children aged 0-17 years.

Methods: Participants (N = 199; median age, 4.69 years; interquartile range, 1.58-10.37; 46.7% male) were recruited in 6 sites across the United States in May-August 2023. Examiners were trained by a pediatric nurse; caregivers received well-developed administration materials. The key anthropometric outcomes assessed were infant length/child height, weight, percent body fat (PBF), head size, and waist circumference. Concordance between caregiver/examiner measurements was assessed using interrater reliability estimates, technical error of measurement (TEM), and mean absolute difference (MAD). Secondary outcomes included reported ease of use and language used.

Results: High concordance was observed between caregivers and examiners, with reliability coefficients ranging from 0.91 to >0.99 and intraclass correlation coefficient values from 0.92 to >0.99 across all assessments and age groups. The TEM was low (height = 2.10 cm, weight = 0.39 kg, PBF = 2.33%; head circumference = 0.73 cm, waist circumference = 3.65 cm) as were MAD estimates (height = 2.12 cm, 95% confidence interval [CI], 1.82-2.42; weight = 0.35 kg, 95% CI, 0.29-0.41; PBF = 2.39%, 95% CI, 1.89-2.88; head size = 0.71 cm, 95% CI, 0.54-0.89; waist circumference = 3.15 cm, 95% CI, 2.41-3.88).

Conclusions: Across multiple metrics, there was high concordance between caregiver- and examiner-administered measurements, providing evidence of interchangeability between remote and in-person assessments of anthropometric outcomes. Remote anthropometric assessment appears feasible and low burden and has comparably high validity and reliability to in-person methods.