Many children improperly measured in doctors’ offices

PHILADELPHIA -- A three-year study conducted by a researcher at the University of Pennsylvania School of Nursing evaluating primary care pediatric practices has found that about two-thirds of children may be improperly measured, possibly leading to the misdiagnosis of growth disorders. The results were reported this week at the Society of Pediatric Research annual meeting in Baltimore.

"Parents look to the growth of their infants and children as one of the leading indicators of their child’s health," said one of the study’s co-principal investigators, nursing professor Terri Lipman. "Yet our study found that due to improper technique and inappropriate equipment, many children are improperly measured."

Lipman and co-principal investigator Karen Hench, president of the Pediatric Endocrinology Nursing Society, found measurements were off by as much as 12 centimeters, or more than 4.5 inches.

"While further research needs to be done, we found children are measured with inaccurate equipment and incorrect technique which yields imprecise measurements," Lipman said. "The implications of that could be that these are children who have growth problems that are unrecognized or are inappropriately referred to specialists when no problem exists."

The $300,000 three-year study funded by the Genentech Foundation for Growth and Development and the Pediatric Endocrinology Nursing Society reviewed the measurement of 660 children in primary care practices in Albany, N.Y., Galveston, Tex., Miami, New Orleans, Philadelphia, Providence, R.I., St. Louis and St. Petersburg, Fla., with pediatric endocrine nurses as site coordinators.

The researchers reviewed linear measurements of children and found only 30 percent of children were measured precisely. After training measurers in proper technique and introducing proper equipment, the researchers found the numbers of children they measured correctly rose to 54 percent.

"Using proper technique and equipment holds the potential for more rapid detection and accurate diagnosis of growth disorders in children," Hench said.

Healthy children grow about 2.5 inches each year. To ensure children are measured properly, there should be a stable, wall-mounted device with a headplate with a fixed right angle. Children should stand without shoes, back, buttocks and heels flat against a hard surface with heels pressed together and eyes looking straight ahead. Toddlers and infants (those two years old and younger) should be measured on a length board.