This study evaluated the accuracy of four height-based equations: blood pressure to height ratio (BPHR), modified BPHR (MBPHR), new modified BPHR (NMBPHR), and height-based equations (HBE) for screening elevated BP in children and adolescents in the SAYCARE study. We measured height and BP of 829 children and adolescents from seven South American cities. Receiving operating curves were used to assess formula performance to diagnose elevated BP in comparison to the 2017 clinical guideline. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the four screening formulas. The diagnostic agreement was evaluated with the kappa coefficient. The HBE equation showed the maximum sensitivity (100%) in children, both for boys and girls, and showed the best performance results, with a very high NPV (>99%) and high PPV (>60%) except for female children (53.8%). In adolescents, the highest sensitivity (100%) was achieved with the NMBPHR for both sexes. Kappa coefficients indicated that HBE had the highest agreement with the gold standard diagnostic method (between 0.70 and 0.75), except for female children (0.57). Simplified methods are friendlier than the percentile gold standard tables. The HBE equation showed better performance than the other formulas in this Latin American pediatric population.
Introduction: Due to the restrictions imposed to control the COVID-19 pandemic, there has been an increase in studies based on online surveys. However, there are important concerns about the validity and generalizability of results from online surveys. Thus, we aimed to test the reliability and validity of the online version of the International Physical Activity Questionnaire short form (IPAQ-SF) among college students from low-income regions. Methods: This was a methodological feasibility study with a random stratified sample from a college located in the state of Maranhão in the city of Imperatriz (Brazil). The sample consisted of 195 college students (at least 17 years of age) to evaluate the validity and 117 students to evaluate the reliability. All data were collected in a self-reported online format (via Google Forms) twice, with an interval of 2 weeks. We used Spearman’s correlation analysis for the reliability study. Additionally, we applied exploratory and confirmatory factor analysis to evaluate the structural validity. Results: The questionnaire showed acceptable (rho > 0.30) and significant (p < 0.05) reliability, except for the question about the duration of sitting time on a weekend day. When assessing the construct validity (exploratory analysis), we identified a single factor that explained 88.8% of the variance. The 1-factor model showed acceptable model fit (SRMR = 0.039; CFI = 0.96; TLI = 0.90) in confirmatory analysis. Conclusions: The online version of the IPAQ-SF has acceptable reliability among college students from low-income regions and maintains the structure of the construct regarding to physical activity.
Objective: This study aimed to test the validity of an automatic oscillometric device to measure the blood pressure (BP) in children (n 5 191) and adolescents (n 5 127) aged 3 to 18 years. Methods: Systolic BP (SBP) and diastolic BP (DBP) levels were measured simultaneous by automatic device and mercury column with Y-connection. To verify the validity, Bland-Altman plots and limits of agreement of 95% (95% LOA), specificity and sensitivity of the device, and the grade of British Hypertension Society (BHS) criteria were used.Results: The monitor measurements demonstrated lower measurement bias (mean difference [95% LOA]): 1.4 (29.9 to 12.8) mmHg in children and 4.3 (27.8 to 16.5) mmHg in adolescents for SBP. For DBP, it was 2.2 (27.4 to 11.7) mmHg in children and 1.4 (28.4 to 11.1) mmHg in adolescents. The sensitivity in children was 21.4 (95% CI 5 16.3-26.6), and in adolescents, it was 20.0 (95% CI 5 13.2-26.8); the specificity was 95.9 (95% CI 5 93.4-98.4) in children and 100.0 (95% CI 5 100.0-100.0) in adolescents. The monitor-tested ratings are Grade B for SBP in children and SBP and DBP in adolescents and Grade C for DBP in children. Conclusions: The automatic monitor presented high values of specificity and lower values of sensitivity to the diagnosis of HBP; however, it can be considered accurate (lower measurement bias) and valid for epidemiological and clinical practice in accordance with BHS criteria.
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