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At least 1,135 records · Page 63Linked to original sources
PubMed2002

Traumatic pneumothorax detection with thoracic US: correlation with chest radiography and CT--initial experience.

PURPOSE: To prospectively compare the accuracy of ultrasonography (US) with that of supine chest radiography in the detection of traumatic pneumothoraces, with computed tomography (CT) as the reference standard. MATERIALS AND METHODS: Thoracic US, supine chest radiography, and CT were performed to assess for pneumothorax in 27 patients who sustained blunt thoracic trauma. US and radiographic findings were compared with CT findings, the reference standard, for pneumothorax detection. For the purpose of this study, the sonographers were blinded to the radiographic and CT findings. RESULTS: Eleven of 27 patients had pneumothorax at CT. All 11 of these pneumothoraces were detected at US, and four were seen at supine chest radiography. In the one false-positive US case, the patient was shown to have substantial bullous emphysema at CT. Sensitivity and negative predictive value of US were 100% (11 of 11 and 15 of 15 patients, respectively), specificity was 94% (15 of 16 patients), and positive predictive value was 92% (11 of 12 patients). Chest radiography had 36% (four of 11 patients) sensitivity, 100% (16 of 16 patients) specificity, a 100% (four of four patients) positive predictive value, and a 70% (16 of 23 patients) negative predictive value. CONCLUSION: In this study, US was more sensitive than supine chest radiography and as sensitive as CT in the detection of traumatic pneumothoraces.

Adolescent↗
PubMed2005

Respiratory dead space measurement in the investigation of pulmonary embolism in outpatients with pleuritic chest pain.

STUDY OBJECTIVES: Pleuritic chest pain is a common presenting condition in the emergency department. A noninvasive bedside rule out test for pulmonary embolism would aid investigating this patient group. Our study aimed to compare the clinical utility of three methods for calculating respiratory dead space in the diagnosis of pulmonary embolism in outpatients with pleuritic chest pain. DESIGN: Prospective diagnostic study. SETTING: Large city-center emergency department. PATIENTS: Between February 2002 and June 2003, 425 patients presenting to the emergency department with pleuritic chest pain were prospectively recruited. INTERVENTION: Data collection for respiratory dead space was performed in the emergency department by two researchers. The respiratory dead space fraction was calculated independently using three different methods. All patients underwent an independent reference standard diagnostic algorithm to establish the presence or absence of pulmonary embolism. Those with a low modified Wells clinical probability and a normal quantitative d-dimer finding were discharged home. All others followed a reference standard protocol using Prospective Investigation of Pulmonary Embolism Diagnosis-interpreted ventilation/perfusion scanning, CT pulmonary angiography, and digital subtraction pulmonary angiography. All patients were followed up clinically for 3 months. MEASUREMENTS AND RESULTS: For the Bohr calculation, the area under the receiver operating characteristic curve was 0.62 (95% confidence interval [CI], 0.51 to 0.73), the Enghoff calculation was 0.66 (95% CI, 0.55 to 0.77), and the capillary sample Enghoff was 0.62 (95% CI, 0.49 to 0.65). The optimum Bohr cutoff value gave 100.0% sensitivity (95% CI, 84.5 to 100%) but a low specificity of 22.7% (95% CI, 18.8 to 27.2%). The optimum cutoff points for Enghoff and capillary Enghoff calculations gave sensitivities of 95.3% (95% CI, 77.3 to 99.2%) and 94.4% (95% CI, 74.2 to 99.0%), respectively, with poor specificity. CONCLUSIONS: Respiratory dead space analysis does not perform well as a stand-alone diagnostic test for pulmonary embolism in outpatients presenting with pleuritic chest pain.

Adult↗
PubMed1995

Accuracy and interlaboratory reliability of human papillomavirus DNA testing by hybrid capture.

Epidemiologists and clinicians wishing to introduce human papillomavirus (HPV) testing into cervical cancer prevention programs need standardized, reliable, and accurate HPV DNA tests that can detect the full spectrum of pathogenic HPV types. The Hybrid Capture System assay from Digene (hybrid capture assay) is a nonradioactive kit designed to detect 14 HPV types in two groups: a mix of 9 high-risk types associated with anogenital cancer (HPV types 16, 18, 31, 33, 35, 45, 51, 52, and 56) and another group of 5 low-risk types associated with condyloma acuminatum (HPV types 6, 11, 42, 43, and 44). The assay yields quantitative data meant to reflect viral concentration. In a study of 199 cervical specimens from women with concurrent Pap smears, we assessed the reliability of the new assay by comparing the hybrid capture assay results from three laboratories. We assessed the accuracy of the hybrid capture assay in comparison with a reference standard of HPV DNA content (multiple testing by several methods in two reference laboratories). We also compared the hybrid capture assay results with the concurrent cytologic diagnoses on the basis of an independent review of each smear by five pathologists. Pairwise interlaboratory agreement rates on HPV positivity for either high-risk or low-risk types ranged from 87 to 94%, and kappa values ranged from 0.61 to 0.83. Among specimens positive for high-risk types (the most important clinical outcome), the interlaboratory correlations of the quantitative data ranged from 0.60 to 0.90. Test results from all three laboratories were strongly associated with those of the HPV DNA reference standard and with the concurrent cytopathologic diagnoses. The most common errors were sporadic, apparently false-positive results.

Cervix Uteri↗
PubMed2005

Radiographers and radiologists reporting plain radiograph requests from accident and emergency and general practice.

AIM: To assess selectively trained radiographers and consultant radiologists reporting plain radiographs for the Accident and Emergency Department (A&E) and general practitioners (GPs) within a typical hospital setting. METHODS: Two radiographers, a group of eight consultant radiologists, and a reference standard radiologist independently reported under controlled conditions a retrospectively selected, random, stratified sample of 400 A&E and 400 GP plain radiographs. An independent consultant radiologist judged whether the radiographer and radiologist reports agreed with the reference standard report. Clinicians then assessed whether radiographer and radiologist incorrect reports affected confidence in their diagnosis and treatment plans, and patient outcome. RESULTS: For A&E and GP plain radiographs, respectively, there was a 1% (95% confidence interval (CI) -2 to 5) and 4% (95% CI -1 to 8) difference in reporting accuracy between the two professional groups. For both A&E and GP cases there was an 8% difference in the clinicians' confidence in their diagnosis based on radiographer or radiologist incorrect reports. For A&E and GP cases, respectively, there was a 2% and 8% difference in the clinicians' confidence in their management plans based on radiographer or radiologist incorrect reports. For A&E and GP cases, respectively, there was a 1% and 11% difference in effect on patient outcome of radiographer or radiologist incorrect reports. CONCLUSION: There is the potential to extend the reporting role of selectively trained radiographers to include plain radiographs for all A&E and GP patients. Further research conducted during clinical practice at a number of sites is recommended.

Confidence Intervals↗
PubMed2006

Liver fibrosis: noninvasive diagnosis with double contrast material-enhanced MR imaging.

PURPOSE: To retrospectively evaluate the accuracy of double contrast material-enhanced (hereafter double-enhanced) magnetic resonance (MR) imaging depiction of hepatic fibrosis, with histopathologic analysis findings as the reference standard. MATERIALS AND METHODS: The institutional review board approved this HIPAA-compliant study and waived the requirement for informed consent. One hundred one patients (58 men, 43 women; mean age +/- standard deviation, 52 years +/- 10) who underwent double-enhanced MR imaging with superparamagnetic iron oxide (SPIO)-enhanced and double-enhanced spoiled gradient-echo (SPGR) sequences between 2001 and 2004 and had a reliable reference standard for the diagnosis of liver fibrosis were included. Two blinded MR radiologists retrospectively scored qualitative (reticulation, nodularity, and total scores) and quantitative (contrast-to-noise ratio between hyperintense and hypointense liver regions, coefficient of variation, and noise-corrected coefficient of variation) liver texture features on MR images in consensus. The image scores for patients with advanced (METAVIR fibrosis score >/= 3) versus those for patients with mild (METAVIR score </= 2) fibrosis were compared, and receiver operating characteristic curves were determined. Diagnostic performance values were calculated at the optimal operating point. Mann-Whitney U and unpaired Student t tests were performed. RESULTS: Qualitative and quantitative image scores were significantly higher for patients with METAVIR fibrosis scores of 3 or higher than for those with scores of 2 or lower (P < .001); on SPIO-enhanced SPGR images, differences increased with increasing echo time. Diagnostic performance for detection of grade 3 or more severe fibrosis was better with the double-enhanced sequence than with the SPIO-enhanced sequences, and qualitative scores had higher diagnostic performance than quantitative scores. The sensitivity, specificity, and accuracy of qualitative scores on double-enhanced SPGR images were higher than 90%. CONCLUSION: Advanced hepatic fibrosis can be detected by using double-enhanced MR imaging. Although diagnostic performance depended on the sequence and scoring system used, sensitivity, specificity, and accuracy values higher than 90% were achievable.

Contrast Media↗
PubMed1987

Evaluation of the nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity.

In view of published results of epidemiologic studies which suggested an association between nitrate in drinking water and human malformations, an assessment of the toxicology of nitrates and nitrites in relation to possible adverse effects on reproduction and development was performed. The current water standard for nitrate is based on protection from methemoglobinemia. A review of the animal data failed to provide evidence for teratogenic effects attributable to nitrate or nitrite ingestion. Adverse reproductive effects reported occurred at doses that were about one thousand times and higher than the estimated human intake. Neither nitrate nor nitrite in experimental animals concentrated in the mammary gland or milk. The present assessment concludes that the maximum contaminant level of 45 ppm nitrate ion, or 10 ppm nitrate-nitrogen, adequately protects the very young from nitrate-induced toxicity, both pre- and postnatally.

Animals↗
PubMedDate not supplied

Comparison of electron beam computed tomography and technetium stress testing in differentiating cause of dilated versus ischemic cardiomyopathy.

OBJECTIVE: The current reference standard for differentiating between nonischemic versus ischemic cardiomyopathy (CM) is angiography. The diagnostic accuracy of nuclear stress testing and electron beam tomography (EBT) was evaluated to differentiate between nonischemic and ischemic CM, using coronary angiography as the reference standard. METHODS: A total of 56 patients who underwent technetium stress testing and coronary angiography for the evaluation of CM were enrolled. Patients then underwent EBT coronary scanning for coronary calcification (CC). RESULTS: Of the 56 patients, 34 (61%) had angiographically significant disease. Using the criteria of ischemia (reversible defect) or infarct (fixed defect) to define a patient with ischemic CM, nuclear stress testing had a sensitivity of 97% (33 of 34 patients) but a specificity of only 18% (4 of 22 patients). Using the criteria of reversible ischemia only, the specificity of nuclear stress testing improved to 50% (P < 0.001); however, the sensitivity decreased to 56%. An EBT score >0 had a sensitivity of 97% (33 of 34 patients) and a specificity of 68% (15 of 22 patients) for defining ischemia. Overall diagnostic accuracy was significantly higher with EBT as compared with nuclear stress testing in this study of patients with reduced ejection fractions (84% vs. 64%; P = 0.009). CONCLUSION: Given the high sensitivity of nuclear testing and EBT, these tests may prove to be an effective screen before angiography in patients with congestive heart failure of unclear cause.

Adult↗
PubMed2006

Identifying observational studies of surgical interventions in MEDLINE and EMBASE.

BACKGROUND: Health technology assessments of surgical interventions frequently require the inclusion of non-randomised evidence. Literature search strategies employed to identify this evidence often exclude a methodological component because of uncertainty surrounding the use of appropriate search terms. This can result in the retrieval of a large number of irrelevant records. Methodological filters would help to minimise this, making literature searching more efficient. METHODS: An objective approach was employed to develop MEDLINE and EMBASE filters, using a reference standard derived from screening the results of an electronic literature search that contained only subject-related terms. Candidate terms for MEDLINE (N = 37) and EMBASE (N = 35) were derived from examination of the records of the reference standard. The filters were validated on two sets of studies that had been included in previous health technology assessments. RESULTS: The final filters were highly sensitive (MEDLINE 99.5%, EMBASE 100%, MEDLINE/EMBASE combined 100%) with precision ranging between 16.7%-21.1%, specificity 35.3%-43.5%, and a reduction in retrievals of over 30%. Against the validation standards, the individual filters retrieved 85.2%-100% of records. In combination, however, the MEDLINE and EMBASE filters retrieved 100% against both validation standards with a reduction in retrieved records of 28.4% and 30.1% CONCLUSION: The MEDLINE and EMBASE filters were highly sensitive and substantially reduced the number of records retrieved, indicating that they are useful tools for efficient literature searching.

Databases, Bibliographic↗
PubMed2004

MRI of fistula in ano: inter- and intraobserver agreement and effects of directed education.

OBJECTIVE: Preoperative MRI of fistula in ano is becoming more common. This prospective study aimed to determine if a significant difference occurred in interpretation between one expert and one novice observer and to assess inter- and intraobserver agreement after both observers underwent a period of directed education. SUBJECTS AND METHODS. An outcome-derived reference standard was defined in 100 patients with suspected fistula in ano via a combination of preoperative MRI, surgical findings, and clinical outcome. The performances of a single expert and a single novice interpreter were compared with this reference standard both before and after a period of directed education, and inter- and intraobserver agreement was determined. RESULTS: Initially the expert correctly classified significantly more fistulas than the novice (85% vs 63%, p = 0.024), but after directed education there was no significant difference, with good agreement for both the classification of the primary track (kappa = 0.71) and identification of extensions (k = 0.61). Intraobserver agreement was very good for the expert (kappa = 0.92) and novice (kappa = 0.88) for classification of the primary track and good (kappa = 0.64 and 0.74, respectively) for identification of extensions. CONCLUSION: The diagnostic accuracy for fistula in ano classification using MRI was significantly higher for one expert than for one novice, though this was rectified by a short period of directed education.

Adult↗
PubMedDate not supplied

Colorimetric determination of total iodine in foods by iodide-catalyzed reduction of Ce+4.

An earlier acid digestion determination of iodine in foods was modified to provide an improved detection limit and to allow for the analysis of a greater variety and larger amounts of foods. The organic material in the sample was oxidized overnight by concentrated nitric acid, followed by digestion in a mixture of concentrated sulfuric and 70% perchloric acid. The iodine was determined by an automated colorimetric method based on the iodide-catalyzed reduction of Ce+4 by As+3. The method had an average relative standard deviation of 3.1% for the samples analyzed, and a detection limit of 0.1 ng/mL in the digested solution and 5 ng/g in a 2 g sample prior to digestion. The recovery of added iodine ranged from 90.3 to 101.3%, using external standards. Samples analyzed included NBS Standard Reference Material 1549, and composites of a variety of dairy products, meat, eggs and fish, cereals, and potatoes. The iodine detected in these samples ranged from 9 ng/g for the potato group to 3360 ng/g for the standard reference material.

Autoanalysis↗
PubMed2006

Highly selective micro-sequential injection lab-on-valve (muSI-LOV) method for the determination of ultra-trace concentrations of nickel in saline matrices using detection by electrothermal atomic absorption spectrometry.

A highly selective procedure is proposed for the determination of ultra-trace level concentrations of nickel in saline aqueous matrices exploiting a micro-sequential injection Lab-On-Valve (muSI-LOV) sample pretreatment protocol comprising bead injection separation/pre-concentration and detection by electrothermal atomic absorption spectrometry (ETAAS). Based on the dimethylglyoxime (DMG) reaction used for nickel analysis, the sample, as contained in a pH 9.0 buffer, is, after on-line merging with the chelating reagent, transported to a reaction coil attached to one of the external ports of the LOV to assure sufficient reaction time for the formation of Ni(DMG)(2) chelate. The non-ionic coordination compound is then collected in a renewable micro-column packed with a reversed-phase copolymeric sorbent [namely, poly(divinylbenzene-co-N-vinylpyrrolidone)] containing a balanced ratio of hydrophilic and lipophilic monomers. Following elution by a 50-muL methanol plug in an air-segmented modality, the nickel is finally quantified by ETAAS. Under the optimized conditions and for a sample volume of 1.8 mL, a retention efficiency of 70 % and an enrichment factor of 25 were obtained. The proposed methodology showed a high tolerance to the commonly encountered alkaline earth matrix elements in environmental waters, that is, calcium and magnesium, and was successfully applied for the determination of nickel in an NIST standard reference material (NIST 1640-Trace elements in natural water), household tap water of high hardness and local seawater. Satisfying recoveries were achieved for all spiked environmental water samples with maximum deviations of 6 %. The experimental results for the standard reference material were not statistically different to the certified value at a significance level of 0.05.

Journal Article↗
PubMed2006

Validation of a novel point-of-care nerve conduction device for the detection of diabetic sensorimotor polyneuropathy.

OBJECTIVE: The diagnosis of diabetic sensorimotor polyneuropathy using objective electrophysiological tests is hindered by limited access to the specialized laboratories and technicians that perform and interpret them. We evaluated the performance characteristics of a novel portable and automated point-of-care nerve conduction study device, which can be operated by nontechnical personnel, and compared it with conventional nerve conduction studies performed in a specialist setting. RESEARCH DESIGN AND METHODS: Seventy-two consecutive patients with diabetes (8 type 1, 64 type 2) from a diabetes and a neuropathy outpatient clinic were evaluated concurrently with conventional nerve conduction studies (the reference standard) and the point-of-care device for sural nerve function (sural nerve amplitude potentials in microvolts [microV]). RESULTS: Sural nerve amplitude potentials measured by the point-of-care device shared very strong correlation with the reference standard (Spearman's correlation coefficient 0.95, P < 0.001). The Bland and Altman method yielded agreement despite a small systematic underestimation by the point-of-care device of 1.2 +/- 3.4 microV. Despite this small systematic bias, the sensitivity and specificity of normal and abnormal sural nerve amplitude potentials measured by the point-of-care device for the detection of diabetic sensorimotor polyneuropathy defined by standard clinical and electrophysiological criteria were 92 and 82%, respectively. CONCLUSIONS: A novel point-of-care device has excellent diagnostic accuracy for detecting electrophysiological abnormality in the sural nerve of patients who have diabetes. This automated device represents an alternative to conventional nerve conduction studies for the diagnosis of diabetic sensorimotor polyneuropathy.

Aged↗
PubMed2003

Postmortem MR imaging of the fetal and stillborn central nervous system.

BACKGROUND AND PURPOSE: Changes in the public perception of postmortem procedures in the United Kingdom have led to reduced numbers of autopsies being performed in the fetus and neonate. When autopsy is performed in this group, the brain is now usually studied without being formalin-fixed, which limits the available information. We evaluated the diagnostic accuracy of postmortem MR imaging of the fetal brain and spine when compared with the reference standard, autopsy. METHODS: We obtained high-spatial-resolution T2-weighted images (in-plane resolution approximately 0.4 mm) of the brain and spine in 40 fetuses and stillborn neonates (14-42 weeks gestational age) who were referred for autopsy. The MR findings were compared with those of autopsy, the reference standard, which had been performed independently. RESULTS: In eight cases, the autopsy did not provide structural information of the brain or spine, because assessment of the unfixed tissue was impossible. There was agreement between MR and autopsy findings in 31 (97%) of 32 cases in which comparison could be made. Eleven cases showed normal brain, and 20 cases showed a wide range of developmental and acquired abnormalities. The sensitivity of MR was 100%, specificity 92%, positive predictive value 95%, and negative predictive value 100%. CONCLUSION: MR imaging has a useful role in providing structural information of the central nervous system in fetuses and stillborn neonates.

Autopsy↗
PubMed1996

[Abdominal emergencies of infectious origin].

Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enerna are commonly performed for the evaluation of signoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures.

Abdomen, Acute↗
PubMed1989

Electrocardiographic quantitation of ventricular repolarization.

Quantification of the electrocardiographic ventricular repolarization involving the T-U wave complex is usually performed with reference to the axis of the T wave and the QT interval duration. A novel quantitative approach to improve the description of ventricular repolarization was applied to the digitized electrocardiograms of 423 normal subjects. Six electrocardiographic repolarization characteristics were identified: duration, rate, area, symmetry, late phenomena, and interlead heterogeneity. A computer algorithm was designed to automatically interpret the electrocardiographic repolarization segment and measure 11 variables that quantified these repolarization characteristics. The application of redundancy-reduction techniques selected a final set of seven variables that were used in the statistical analysis. The QT interval, which was included in the initial group of variables, was replaced by the time interval between S wave offset and T wave maximum. All selected electrocardiographic variables were independent of age (r2 less than 0.11) and body surface area (r2 less than 0.03); all except the early duration variable were heart rate- and QT interval-independent (r2 less than 0.2, r2 less than 0.13, respectively; and most were uncorrelated to each other. A comparison of repolarization characteristics by gender revealed that repolarization duration was significantly more prolonged (p less than 0.0001) in women than in men. This multidimensional quantitative approach conveys a new and more complete description of the repolarization process and provides an electrocardiographic repolarization database in normal subjects as a reference standard for identifying patients with disordered repolarization.

Adult↗
PubMed1982

Chemostat studies of the effect of environmental control on Streptococcus sanguis adherence to hydroxyapatite.

Streptococcus sanguis is a major component of early dental plaque. The ability of S. sanguis to adhere to salivary pellicle appears to involve specific bacterial surface receptors. The nature of these receptors is still not known; however, the component molecules may be subject to environmental control as has been shown for teichoic acids and certain proteins. To study these environmental effects, a chemostat was employed to vary the growth conditions of Streptococcus sanguis strain G9B. This strain has been used extensively to study the adhesion of [(3)H]thymidine-labeled batch-grown cells to saliva-coated hydroxyapatite beads. The effects of dilution rate, pH, and carbon source on adhesion were studied with a competition assay in which the labeled batch cells were used as a reference standard. In this assay, cells from the chemostat were harvested and compared for their ability to inhibit adhesion of labeled cells relative to unlabeled control batch-grown cells. Subsequent studies used chemostat grown cells labeled with [(3)H]thymidine as a reference standard so that results were internally controlled and reflected only the particular alteration in environment which was studied. These results indicated that when glucose was used as a growth-limiting substrate, cells grown at relatively high dilution rates (D = 0.5 h(-1); mean generation time = 1.4 h) behaved similarly to batch-grown cells and appeared to compete for the same binding sites. Cells grown at D = 0.1 h(-1) (mean generation time = 7 h) no longer competed with either batch-grown cells or chemostat cells grown at D = 0.5 h(-1). Moreover, adsorption isotherms of such slow-growing cells (D = 0.1 h(-1)) suggested that binding was no longer specific. When fructose was used as the growth-limiting carbohydrate, cells grown at D = 0.1 h(-1) did not show this loss of specificity and competed nearly as well as control batch-grown glucose cells. However, the effect of pH appeared to be independent of carbohydrate source, because cells grown in either glucose or fructose at pH 5.5 at D = 0.1 h(-1) lost the ability to compete with reference batch or chemostat cells grown at D = 0.5 h(-1). This effect was very sharp, since cells grown in the pH range from 6 to 7.5 at D = 0.5 h(-1) competed nearly as well as control cells. A similar effect of pH was found for batch cultures grown with excess glucose. These studies reinforce the idea that the environment can profoundly affect the bacterial surface and consequently the ability of the organism to adhere, a property which appears to be a primary event in some infectious diseases and in dental plaque formation.

Adhesiveness↗
PubMed1995

Is the lesser growth of African schoolchildren essentially prejudicial to their present and future health?

In African and other Third World countries, 20-50% of schoolchildren lie under the 5th centile of US National Center for Health Statistics (NCHS) growth reference standards for weight- and height-for-age. Such lesser growth, orthodoxly, categorizes those affected as malnourished, at greater risk of disease, of lesser intelligence, and in need of nutritional supplementation. Questions arising include: 'Are there limitations to the application of NCHS reference standards?' In African schoolchildren, is lesser growth attributable largely, or marginally, to insufficient food intake? How powerful are the non-dietary influencing factors? What are the associated disadvantages to health? Conversely, could lesser growth around puberty even be beneficial respecting possible lessening of subsequent risk of degenerative diseases? Discussion indicates that there are numerous complexities in the whole subject of anthropometry, malnutrition and its stigmata, and interventions, dietary and non-dietary, in the youth of poor populations. In view of the invariably low health funds available in Third World countries, only intervention measures of proven significance to pupils' health warrant implementation.

Africa↗
PubMed1989

Assessment of growth: is one international growth reference sufficient?

There is no definitive conclusion concerning the long-debated issue of whether one international growth reference is sufficient for assessing the growth of all children regardless of racial background. Although nurses and health professionals in North America primarily use the National Health Centre for Health Statistics growth reference data to identify atypical growth, recognizing potential abnormalities in non-Caucasians remains difficult. After exploring the issues surrounding this question, the authors concluded that an international growth reference is required to provide a common point of comparison of growth for the population groups from different countries. Arguments can be made for developing reference standards for particular racial groups, although several difficulties and limitations preclude this.

Body Height↗