Toronto Metropolitan University
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Reliability of routinely collected anthropometric measurements in primary care

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journal contribution
posted on 2023-09-20, 17:08 authored by Sarah Carsley, Patricia C. Parkin, Karen Tu, Eleanor Pullenayegum, Nav PersaudNav Persaud, Jonathon L. Maguire, Catherine S. Birken, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Laura N. Anderson, Cornelia M. Borkhoff, David W. H. Dai, Christine Kowal, Dalah Mason, Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Fok-Han Leung, Alan Li, Patricia Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Rosemary Moodie, Julia Morinis, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Christine Koroshegyi, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson, Mary Aglipay, Imaan Bayoumi, Katherine Cost, Karen Eny, Theresa Kim, Laura M. Kinlin, Jessica OmandJessica Omand, Shelley Vanderhout, Leigh Vanderloo


Measuring body mass index (BMI) has been proposed as a method of screening for preventive primary care and population surveillance of childhood obesity. However, the accuracy of routinely collected measurements has been questioned. The purpose of this study was to assess the reliability of height, length and weight measurements collected during well-child visits in primary care relative to trained research personnel.


A cross-sectional study of measurement reliability was conducted in community pediatric and family medicine primary care practices. Each participating child, ages 0 to 18 years, was measured four consecutive times; twice by a primary care team member (e.g. nurses, practice personnel) and twice by a trained research assistant. Inter- and intra-observer reliability was calculated using the technical error of measurement (TEM), relative TEM (%TEM), and a coefficient of reliability (R).


Six trained research assistants and 16 primary care team members performed measurements in three practices. All %TEM values for intra-observer reliability of length, height, and weight were classified as ‘acceptable’ (< 2%; range 0.19% to 0.70%). Inter-observer reliability was also classified as ‘acceptable’ (< 2%; range 0.36% to 1.03%) for all measurements. Coefficients of reliability (R) were all > 99% for both intra- and inter-observer reliability. Length measurements in children < 2 years had the highest measurement error. There were some significant differences in length intra-observer reliability between observers.


There was agreement between routine measurements and research measurements although there were some differences in length measurement reliability between practice staff and research assistants. These results provide justification for using routinely collected data from selected primary care practices for secondary purposes such as BMI population surveillance and research.




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