title: Measurement error of waist circumference: gaps in knowledge.
abstract: OBJECTIVE
  It is not clear whether measuring waist circumference in clinical practice is problematic because the measurement error is unclear, as well as what constitutes a clinically relevant change. The present study aimed to summarize what is known from state-of-the-art research.
  
  
  METHODS
  To identify the magnitude of the measurement error of waist circumference measurements from the literature, a search was conducted in PubMed from 1975 to February 2011.
  
  
  RESULTS
  The measurement error may vary between 0·7 cm and 15 cm. Taking a realistic range of measurable waist circumference into account (60-135 cm), we argue that a short-term clinically relevant change in waist circumference of 5 % may lie between 3·0 and 6·8 cm and a maintained clinically relevant change of 3 % between 1·8 and 4·1 cm.
  
  
  CONCLUSIONS
  Based on these results, we conclude it may be difficult to distinguish clinically relevant change from measurement error in individual subjects, due to the large measurement error and unclear definition of clinically relevant change. More research is needed to address these gaps in knowledge. To minimize measurement error, we recommend using a uniform measurement protocol, training and repeated measurements.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
authors.forename: Lisanne M
authors.initials: LM
authors.lastname: Verweij
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Terwee
authors.forename: Karin I
authors.initials: KI
authors.lastname: Proper
authors.forename: Carel T J
authors.initials: CT
authors.lastname: Hulshof
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
mesh_terms: D000886:Anthropometry / Q000379:methods*; D003951:Diagnostic Errors; D006801:Humans; D056128:Obesity, Abdominal / Q000175:diagnosis*; D055105:Waist Circumference