Objective: to compare the usefulness of the methods proposed by Gomez, Waterlow and W.H.O., to classify the nutritional status of children under 2 years of age. Method: the nutritional diagnosis of 436 infants was defined at 6, 12, 18 and 24 months of age, using the three proposed methods. Predictive values, positive (PV+) and negative(PV-), and agreement coefficient(K) were calculated, comparing the nutritional classification of the children on each method with a golden standard of nutritional diagnosis, based on individual growth performance since their birth. Results: the three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age. Conclusions: the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life, when the risk of a false positive diagnosis of malnutrition is still higher.
Objectiveto compare the usefulness of the methods proposed by Gomez, Waterlow and W.H.O., to classify the nutritional status of children under 2 years of age. Method: the nutritional diagnosis of 436 infants was defined at 6, 12, 18 and 24 months of age, using the three proposed methods. Predictive values, positive (PV+) and negative(PV-), and agreement coefficient(K) were calculated, comparing the nutritional classification of the children on each method with a golden standard of nutritional diagnosis, based on individual growth performance since their birth. Results: the three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age. Conclusions: the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life, when the risk of a false positive diagnosis of malnutrition is still higher.
Methodthe nutritional diagnosis of 436 infants was defined at 6, 12, 18 and 24 months of age, using the three proposed methods. Predictive values, positive (PV+) and negative(PV-), and agreement coefficient(K) were calculated, comparing the nutritional classification of the children on each method with a golden standard of nutritional diagnosis, based on individual growth performance since their birth. Results: the three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age. Conclusions: the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life, when the risk of a false positive diagnosis of malnutrition is still higher.
Resultsthe three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age. Conclusions: the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life, when the risk of a false positive diagnosis of malnutrition is still higher.
Conclusionsthe Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life, when the risk of a false positive diagnosis of malnutrition is still higher.
comparar as classificações antropométricas propostas por Gomez, Waterlow e OMS na avaliação do estado nutricional de crianças até 24 meses de idade.
Casuística e Métodosem um grupo de 436 crianças, estabeleceu-se o diagnóstico nutricional individual aos 6, 12, 18 e 24 meses de idade, pelas classificações de Gomez, Waterlow e OMS, comparando-o com o diagnóstico nutricional padrão (Golden standard: evolução ponderal do nascimento até a avaliação), pelos seus valores preditivos: positivo (VP+) e negativo (VP-) e coeficiente de concordância (K).
Resultadosas três classificações revelaram bons VP-, próximos de 0,9, em todas as idades. Entretanto os VP+ e K se apresentaram sempre inferiores, com tendência a melhorar no segundo ano de vida. Dentre as classificações, a de Gomez foi a que apresentou melhores valores de VP+, VP- e de K, em todas as idades.
Conclusõesa classificação de Gomez, quando for necessária uma avaliação isolada, não se conhecendo a evolução da criança, mostrou ser a que possui menor probabilidade de levar a erro. Apesar disto, sua margem de erro é suficiente para não recomendar sua utilização como único critério diagnóstico, principalmente no primeiro ano de vida, quando o risco de um diagnóstico positivo falso é mais elevado.
