ArticlePloS one2018
Optimisation of children z-score calculation based on new statistical techniques.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Conflict and Child Malnutrition: a Systematic Review of the Emerging Quantitative Literature.Current nutrition reports · 2022Pooled it
- Early-life physical activity and risk of juvenile idiopathic arthritis: a longitudinal ABIS cohort study using a symptom-free baseline design.Pediatric rheumatology online journal · 2026Article
- Parental and Peer Relationships and Their Impact on Symptom Severity in Adolescent Patients With Anorexia Nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2026Article
- Towards a more reliable assessment of aortic diameters using a Bayesian Z-score.Scientific reports · 2026Article
- A practical ML framework for biomass torrefaction analysis and simulator deployment.Scientific reports · 2026Article
- Impact of growth hormone treatment on childhood growth patterns in Kermanshah: A retrospective cohort study.Journal of education and health promotion · 2026Article
- Hidden Hunger in Pediatric Obesity: Redefining Malnutrition Through Macronutrient Quality and Micronutrient Deficiency.Nutrients · 2025Review
- Early Life Physical Activity May Reduce the Risk of Developing Type 1 Diabetes: The Longitudinal ABIS Study.Diabetes/metabolism research and reviews · 2025Article
- Impact of maternal body mass index (BMI) and gestational weight gain on offspring's weight and BMI z-scores across the first 8 years of life.Clinical obesity · 2025Article
- The role of parental health knowledge and practices in mitigating obesity risks among preschool children.Scientific reports · 2025Article
- Optimal Gestational Weight Gain and Fetal Growth in Urban Environments: The Role of Residential Greenness.Environment & health (Washington, D.C.) · 2025Article
- Identifying texture features from structural magnetic resonance imaging scans associated with Tourette's syndrome using machine learning.Journal of medical imaging (Bellingham, Wash.) · 2025Article
- Impairments in personality functioning in adolescents with anorexia nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2025Article
- Nutritional support in children treated for advanced adrenocortical carcinoma.Pediatric surgery international · 2025Observational
- Integrating Genetic Insights, Technological Advancements, Screening, and Personalized Pharmacological Interventions in Childhood Obesity.Advances in therapy · 2025Review
- Evaluating an acceptance-based lifestyle modification program to address cardiovascular disease risk among adolescent girls with overweight and obesity: Protocol for a randomized controlled trial.Contemporary clinical trials · 2024Article
- Different Eating Habits Are Observed in Overweight and Obese Children Than in Normal-Weight Peers.Children (Basel, Switzerland) · 2024Article
- Predicting Marfan Syndrome in Children With Congenital Ectopia Lentis: Development and Validation of a Nomogram.Translational vision science & technology · 2024Article
- Inter-scanner comparability of Z-scores for native myocardial T1 and T2 mapping.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Article
- Electrocardiographic measurements in children with pre-dialysis chronic kidney disease and undergoing kidney replacement therapy.European journal of pediatrics · 2023Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExpressing anthropometric parameters (height, weight, BMI) as z-score is a key principle in the clinical assessment of children and adolescents. The Centre for Disease Control and Prevention (CDC) growth charts and the CDC-LMS method for z-score calculation are widely used to assess growth and nutritional status, though they can be imprecise in some percentiles.
objectiveTo improve the accuracy of z-score calculation by revising the statistical method using the original data used to develop current z-score calculators.
designA Gaussian Process Regressions (GPR) was designed and internally validated. Z-scores for weight-for-age (WFA), height-for-age (HFA) and BMI-for-age (BMIFA) were compared with WHO and CDC-LMS methods in 1) standard z-score cut-off points, 2) simulated population of 3000 children and 3) real observations 212 children aged 2 to 18 yo.
resultsGPR yielded more accurate calculation of z-scores for standard cut-off points (p<<0.001) with respect to CDC-LMS and WHO approaches. WFA, HFA and BMIFA z-score calculations based on the 3 different methods using simulated and real patients, showed a large variation irrespective of gender and age. Z-scores around 0 +/- 1 showed larger variation than the values above and below +/- 2.
conclusionThe revised z-score calculation method was more accurate than CDC-LMS and WHO methods for standard cut-off points. On simulated and real data, GPR based calculation provides more accurate z-score determinations, and thus, a better classification of patients below and above cut-off points. Statisticians and clinicians should consider the potential benefits of updating their calculation method for an accurate z-score determination.
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