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      A collaborative, mixed‐methods evaluation of a low‐cost, handheld 3D imaging system for child anthropometry

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          Abstract

          3D imaging for body measurements is regularly used for design of garments and ergonomic products. The development of low‐cost 3D scanners provided an opportunity to extend the use of 3D imaging to the health sector. We developed and tested the AutoAnthro System, the first mobile, low‐cost, full‐body, 3D imaging system designed specifically for child anthropometry. This study evaluated the efficiency, invasiveness, and user experience of the AutoAnthro System. We used a mixed‐methods, collaborative approach that included a quantitative time‐motion study and qualitative interviews of anthropometrists. For cooperative children, anthropometrists considered the use of 3D imaging an easy, “streamlined experience,” but with uncooperative children, anthropometrists reported that capturing a good quality scan was out of their control. The mean time to complete a full set of scans was 68 s (standard deviation [SD] 29), compared with 135 s (SD 22) for a set of manual measurements (stature, head circumference, and arm circumference). We observed that crying was more common during manual measurement, and anthropometrist interviews confirmed that 3D imaging was less stressful for children than manual measurement. In a previous publication, we showed the potential of 3D imaging to produce reliable and accurate measurements. In this study, we found that anthropometrists were not ready to abandon manual equipment for 3D scanners because of difficulty in measuring uncooperative children. Revising the AutoAnthro System to address anthropometrists' concerns on capturing good quality scans of uncooperative children should help to facilitate widespread use of 3D imaging for child anthropometry.

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          Most cited references18

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          Time motion studies in healthcare: what are we talking about?

          Time motion studies were first described in the early 20th century in industrial engineering, referring to a quantitative data collection method where an external observer captured detailed data on the duration and movements required to accomplish a specific task, coupled with an analysis focused on improving efficiency. Since then, they have been broadly adopted by biomedical researchers and have become a focus of attention due to the current interest in clinical workflow related factors. However, attempts to aggregate results from these studies have been difficult, resulting from a significant variability in the implementation and reporting of methods. While efforts have been made to standardize the reporting of such data and findings, a lack of common understanding on what "time motion studies" are remains, which not only hinders reviews, but could also partially explain the methodological variability in the domain literature (duration of the observations, number of tasks, multitasking, training rigor and reliability assessments) caused by an attempt to cluster dissimilar sub-techniques. A crucial milestone towards the standardization and validation of time motion studies corresponds to a common understanding, accompanied by a proper recognition of the distinct techniques it encompasses. Towards this goal, we conducted a review of the literature aiming at identifying what is being referred to as "time motion studies". We provide a detailed description of the distinct methods used in articles referenced or classified as "time motion studies", and conclude that currently it is used not only to define the original technique, but also to describe a broad spectrum of studies whose only common factor is the capture and/or analysis of the duration of one or more events. To maintain alignment with the existing broad scope of the term, we propose a disambiguation approach by preserving the expanded conception, while recommending the use of a specific qualifier "continuous observation time motion studies" to refer to variations of the original method (the use of an external observer recording data continuously). In addition, we present a more granular naming for sub-techniques within continuous observation time motion studies, expecting to reduce the methodological variability within each sub-technique and facilitate future results aggregation.
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            Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

            To identify ways for improving the consistency of design, conduct, and results reporting of time and motion (T&M) research in health informatics. We analyzed the commonalities and divergences of empirical studies published 1990-2010 that have applied the T&M approach to examine the impact of health IT implementation on clinical work processes and workflow. The analysis led to the development of a suggested 'checklist' intended to help future T&M research produce compatible and comparable results. We call this checklist STAMP (Suggested Time And Motion Procedures). STAMP outlines a minimum set of 29 data/ information elements organized into eight key areas, plus three supplemental elements contained in an 'Ancillary Data' area, that researchers may consider collecting and reporting in their future T&M endeavors. T&M is generally regarded as the most reliable approach for assessing the impact of health IT implementation on clinical work. However, there exist considerable inconsistencies in how previous T&M studies were conducted and/or how their results were reported, many of which do not seem necessary yet can have a significant impact on quality of research and generalisability of results. Therefore, we deem it is time to call for standards that can help improve the consistency of T&M research in health informatics. This study represents an initial attempt. We developed a suggested checklist to improve the methodological and results reporting consistency of T&M research, so that meaningful insights can be derived from across-study synthesis and health informatics, as a field, will be able to accumulate knowledge from these studies.
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              BMI compared with 3-dimensional body shape: the UK National Sizing Survey.

              Human body shape is a rich source of information about health and the risk of disease. Measuring anthropometry manually is time-consuming, however, and only a few indexes of shape (eg, body girths and their ratios) are used regularly in clinical practice or epidemiology, both of which still rely primarily on body mass index (BMI). Three-dimensional (3-D) body scanning provides high-quality digital information about shape. The objectives of the study were to investigate the relation of shape and BMI and to examine associations between age, sex, and shape. In a cross-sectional study of 9617 adults (45% male) aged 16-91 y who were participating in the UK National Sizing Survey, body girths and their ratios were obtained with the use of a 3-D body scan. Data on weight and height were also obtained. BMI was significantly associated with chest and waist in men and with hips and bust in women. In early adulthood, the sexes differed significantly in shape; however, these differences declined with age. Whereas male shape remained highly stable through adulthood, upper body girths, particularly waist, increased in women, but thigh decreased. After adjustment for other girths, waist was significantly and inversely associated with height, particularly in men. Waist varied widely in both sexes for a given BMI value. Relations between BMI and shape differed significantly between the sexes, particularly in association with age. The inverse association between height and waist in men suggests either a genetic contribution or a link between early growth pattern and predisposition to obesity. The 3-D scans offer a novel approach for epidemiologic research into associations between body shape and health risks and outcomes.
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                Author and article information

                Contributors
                joelconkle@gmail.com , jconkle@emory.edu
                Journal
                Matern Child Nutr
                Matern Child Nutr
                10.1111/(ISSN)1740-8709
                MCN
                Maternal & Child Nutrition
                John Wiley and Sons Inc. (Hoboken )
                1740-8695
                1740-8709
                18 October 2018
                April 2019
                : 15
                : 2 ( doiID: 10.1111/mcn.2019.15.issue-2 )
                : e12686
                Affiliations
                [ 1 ] Doctoral Program in Nutrition and Health Sciences Laney Graduate School, Emory University Atlanta Georgia
                [ 2 ] Hubert Department of Global Health, Rollins School of Public Health Emory University Atlanta Georgia
                [ 3 ] Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion. U.S. Centers for Disease Control and Prevention Atlanta Georgia
                [ 4 ] Department of Pediatrics, School of Medicine Emory University Atlanta Georgia
                Author notes
                [*] [* ] Correspondence

                Joel Conkle, Doctoral Program in Nutrition and Health Sciences. Laney Graduate School. Emory University, 201 Dowman Dr., Atlanta, GA 30307.

                Email: jconkle@ 123456emory.edu ; joelconkle@ 123456gmail.com

                Author information
                http://orcid.org/0000-0003-2603-5052
                Article
                MCN12686 MCN-11-17-OA-2874.R1
                10.1111/mcn.12686
                6519116
                30194911
                98f4e1b6-88eb-4654-bdf3-a420689d665e
                © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 November 2017
                : 02 January 2018
                : 16 January 2018
                Page count
                Figures: 1, Tables: 3, Pages: 0, Words: 5850
                Funding
                Funded by: Bill & Melinda Gates Foundation
                Award ID: OPP1132308
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                mcn12686
                April 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:31.05.2019

                3d,anthropometry,height,length,nutritional status,user experience

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