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. 2024 Dec 5;24(1):298.
doi: 10.1186/s12874-024-02405-0.

Facilitating comprehensive child health monitoring within REDCap - an open-source code for real-time Z-score assessments

Priyanka Mendon #  1 , Michael Witsch #  2 , Marianne Becker  2 , Aurélie Adamski  2 , Michel Vaillant  3
Affiliations

Facilitating comprehensive child health monitoring within REDCap - an open-source code for real-time Z-score assessments

Priyanka Mendon et al. BMC Med Res Methodol. .

Abstract

Background: Monitoring of somatic development through the assessment of anthropometric variables such as weight, height, and BMI is vital for evaluating the physical development and nutritional status of children. This approach aids in the early identification of somatic developmental disorders, enabling timely medical interventions. It traditionally relies on Z-scores, which compare anthropometric variables with reference standards. In addition to somatic development monitoring, the early detection and management of pediatric and adolescent hypertension are crucial due to potential long-term health risks. However, manual calculations of Z-scores are time-consuming and error-prone, impeding timely interventions for at-risk children. This article introduces an innovative open-code solution for real-time Z-score assessments directly within the electronic data capture platform, Research Electronic Data Capture, (REDCap™), aiming to streamline the monitoring of somatic development in children.

Methods: Leveraging the World Health Organization (WHO) growth standards and National Health and Nutrition Examination Survey (NHANES) references, our approach integrates Z-score computations directly into REDCap, providing a secure and user-friendly environment for healthcare professionals and researchers. We employed Bland-Altman analyses to compare our method with established calculators (Knirps and Growth XP™) using synthetic data values for all variables.

Results: Bland-Altman plots demonstrated strong agreement between our REDCap calculations and the Knirps and Growth XP systems. Z-scores for height, BMI, and blood pressure consistently aligned, affirming the accuracy of our approach across the measurement range.

Conclusion: The integration with REDCap streamlines data collection and analysis, eliminating the need for separate software and data exports. Moreover, our solution uses the World Health Organization (WHO) growth standards and National Health and Nutrition Examination Survey (NHANES) references. This not only ensures calculation accuracy but also enhances its suitability for diverse research contexts. The Bland-Altman analyses establish the reliability of our method, contributing to a more effective approach to child growth and blood pressure monitoring.

Keywords: Open Code; REDCap; Real-time calculations; Somatic development monitoring; World Health Organization (WHO) growth standards; Z-Scores.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Screen capture of REDCap notification when calculated fields are updated
Fig. 2
Fig. 2
Screencapture of REDCap data quality module, rule H window describing the list of calculated fields requiring review
Fig. 3
Fig. 3
Screengrab of REDCap dashboard. “Online designer” module is used to create data entry fields
Fig. 4
Fig. 4
Screen capture of the KNIRPS calculator. The Z-scores are highlighted inside the green boxes
Fig. 5
Fig. 5
Screen capture of REDCap database. The Z-scores are highlighted inside the green boxes
Fig. 6
Fig. 6
Screen capture of GrowthXp for the calculated Z-scores [25]
Fig. 7
Fig. 7
Bland Altman plots for demonstrating strong agreement between REDCap solution, Knirps calculator and the Growth XP system [26]
Fig. 8
Fig. 8
Screen capture of REDCap logic editor module highlighting the validity of the entered logic
Fig. 9
Fig. 9
Summary of the research article
See this image and copyright information in PMC

References

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