Weight velocity equations with 14-448 days time separated weights should not be used for infants under 3 years of age.

ABSTRACT

Abnormal growth of infants may indicate disease of the children, thus methods to identify growth disorders are wanted in medicine. We previously showed that two-time-points weight growth velocities at age t, calculated by a commercial software product as [Weight(t) - Weight(t - X)]/X, with X = 448 days, were erroneous due to the long separation of 448 days. We were convinced that shorter X-values would solve this accuracy problem. However, our hypothesis is that "shorter time separations than 448 days cause a decreased accuracy of numerical weight velocity equations in realistic infant weights until an age of about three years". Supporting evidence comes from analyzing how shorter X-values will affect the accuracy of two-time-points weight velocity calculations. We systematically varied X between 1 and 448 days of various P50/0SD-related standard weight curves (a) P50/0SD with the weights separated by 1 day and X = 1,28,224,448 days; (b) P50/0SD with the weights at variable ages and X = 14-448 days; and (c) case (b) and incorporating weight fluctuations typically occurring in infants. Cases (b) and (c) include details observed in a clinical case. Our results show that the combination of weight fluctuations and varying time intervals between consecutive weights make weight velocity predictions worse for shorter X values in children younger than three years. Because these two causes of failure occur naturally in infants whose weight is regularly measured, other weight velocity equations face the same causes for inaccuracy. In conclusion, our hypothesis suggests that any software that predicts weight velocities should be abandoned in infants < 3 years. Practically, it should require that when (commercial) software weight velocity prediction suggests a medical problem, careful clinical checking should be mandatory, e.g. by linking predicted and exact weight velocities at age t (the latter from the mathematical first derivative at age t of standard weight curves).