title: A Prospective Evaluation of the Accuracy of Weight Estimation Using the Broselow Tape in Overweight and Obese Pediatric Patients in the Emergency Department.
abstract: OBJECTIVE
  The aims of the study were to examine the predictive accuracy of Broselow tape (BT) weight estimation and body mass index-based weight categorization in overweight and obese pediatric patients and to develop an adjustment factor that improves the BT weight estimate in overweight and obese pediatric patients.
  
  
  METHODS
  A prospective observational study was conducted. We enrolled noncritical pediatric patients presenting to a tertiary care pediatric emergency department with nonurgent complaints. Patients had their weights, heights, abdominal circumferences, and actual BT measurements documented by research staff.
  
  
  RESULTS
  One hundred seventy-eight patients aged 2 to 18 years were enrolled. Using the Centers for Disease Control and Prevention's definition of body mass index classification, 71 patients (39.89%) had normal BMI, 43 patients (24.16%) were overweight, and 64 patients (35.96%) were obese. The accuracy of the BT-estimated weight range, compared with the actual weight, is 40.5% in our study population. When stratified by BMI classification, the accuracy proportions were the following: 71.8% for normal, 41.9% for overweight, and 4.7% for obese patients. The adjustment formula ([0.014 × waistline in cm + 0.3] × BT weight) improved overall weight estimation from 40.5% to 65.2%. The greatest improvement was noted in obese children, where the BT accuracy improved from 4.7% to 59.4%.
  
  
  CONCLUSIONS
  The growing pediatric obesity epidemic has challenged the BT's ability to accurately estimate the weights in overweight and obese pediatric patients. Our study demonstrated inverse relationship between the accuracy of BT and body weight. An adjustment factor significantly improved BT accuracy in obese children.
authors.affiliation: From the *Cook Children's Hospital, Forth Worth; †Department of Pediatrics, Division of Pediatric Emergency Medicine, UT Southwestern; and ‡Children Medical Center, Dallas, TX.
authors.forename: Dennis
authors.initials: D
authors.lastname: Tanner
authors.forename: Ashley
authors.initials: A
authors.lastname: Negaard
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.forename: Neil
authors.initials: N
authors.lastname: Evans
authors.forename: Halim
authors.initials: H
authors.lastname: Hennes
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D001837:Body Weights and Measures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results