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      Padronização e confiabilidade das medidas antropométricas para pesquisa populacional Translated title: Standardization and reliability of anthropometric measurements for population surveys.

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          Abstract

          O objetivo do presente estudo foi padronizar e determinar a confiabilidade das medidas realizadas por cinco antropometristas de uma pesquisa populacional. A padronização, com conteúdos teóricos e práticos relativos à técnica de mensuração antropométrica, foi realizada em setembro de 2006 e março de 2007, quando foram aferidos o erro técnico de medição (ETM) intra-avaliador e interavaliador, respectivamente. Para determinar o ETM intra-avaliador, 107 escolares foram avaliados em dois dias distintos. Para a aferição do ETM inter-avaliadores, 22 escolares foram avaliados um de cada vez, durante o mesmo período, pelos cinco avaliadores e por um avaliador padrão. De forma geral, o resultado de ETM absoluto intraavaliador para as dobras cutâneas foi menor que 1 mm. Para as circunferências quase todos tiveram valores menores que 1 cm. A análise do ETM relativo intra-avaliador indica que, para as dobras cutâneas subescapular, suprailíaca e panturrilha medial a maioria dos valores esteve acima dos valores limites para antropometristas iniciantes. Quase todos os valores de R intra-avaliadores foram maiores que 0,95 para as dobras cutâneas e maiores que 0,99 para as circunferências. Observa-se que os resultados de ETM absoluto e de R do estudo interavaliador foram similares aos do estudo intraavaliador. Em relação ao ETM relativo interavaliador verificou-se uma melhora dos antropometristas, devido a maior ocorrência de valores dentro dos limites aceitáveis. Este estudo mostrou que após a realização de duas aferições do ETM, os antropometristas melhoraram seu desempenho e pode-se considerar que o processo de treinamento e de padronização de medidas antropométricas foi bem sucedido.

          Translated abstract

          In this paper we describe the standardization and reliability of anthropometric measurements carried out by five population survey anthropometrists. For the standardization of anthropometric measurement techniques, one expert anthropometrist conducted two theoretical and practical workshops, in September 2006 and March 2007, where the intra- and interobserver technical errors of measurement (TEMs) were assessed, respectively. For the intraobserver assessment of anthropometric measurements, we studied 121 schoolchildren on two different days. For interobserver assessment, we studied 22 schoolchildren that were measured, during the same period, once by each of the five anthropometrists and by an expert anthropometrist. For skinfold thickness, intraobserver TEMs in general were smaller than 1 mm; for circumferences, TEMs in general were smaller than 1 cm. For the subscapular, suprailiac and calf skinfolds, the intraobserver relative TEMs were greater than the acceptable limit for beginner anthropometrists. Intraobserver reliability for skinfold thickness was greater than 0.95 and for circumferences was greater than 0.99 in almost all cases. The results of interobserver TEMs and reliability were similar to intraobserver assessment. The anthropometrists performed better in the intraobserver relative TEMs because their values were smaller than the acceptable limit. We conclude that the anthropometrists showed a better performance after two assessments of the error of measurement. This suggests that the standardization process of anthropometric measurements was carried out with success.

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          Most cited references29

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          Physical Status: The Use and Interpretation of Anthropometry

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            Physical Status: The Use and Interpretation of Antropometry

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              Anthropometric measurement error and the assessment of nutritional status.

              Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                alan
                Archivos Latinoamericanos de Nutrición
                ALAN
                Sociedad Latinoamericana de Nutrición (Caracas )
                0004-0622
                December 2007
                : 57
                : 4
                : 335-342
                Affiliations
                [1 ] Universidade Federal de Santa Catarina Brasil
                Article
                S0004-06222007000400005
                18524317
                cdf39458-2080-4400-9ca1-777b14234488

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                Categories
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Standardization,anthropometry,nutrition assessment,Padronização,antropometria,avaliação nutricional

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