{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:06:51Z","timestamp":1789538811518,"version":"build-2803163510"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to validate the Pediatric Advanced Weight Prediction in the Emergency Room Extra Large-Mid-Arm Circumference (PAWPER XL-MAC) weight estimation scale in Turkish children by evaluating its accuracy, agreement, and validity across age groups. We assessed the scale's performance using mid-arm circumference (MAC), habitus status (HS), and height to predict weight, while examining age- and gender-related differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included pediatric patients (aged 0\u201318 years) who presented to a pediatric surgery outpatient clinic from December 2024 to April 2025. Data on demographics, height, weight, MAC, and clinician-assigned HS (1\u20137) were collected. PAWPER XL-MAC estimated weights were calculated. Accuracy was assessed using percentage within 10% (PW10) and percentage within 20% (PW20). Analyses included descriptive stats, Pearson correlations,\n                      <jats:italic>t<\/jats:italic>\n                      -tests\/Welch's\n                      <jats:italic>t<\/jats:italic>\n                      -tests, ANOVA, multiple regression, Bland\u2013Altman plots, and confirmatory factor analysis (CFA) for validity measures. SPSS, R, and Jamovi were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort comprised 323 boys (65.8%) and 168 girls (34.2%), for a total of 491 patients, with infants (0\u20132 years) forming the largest group (41.8%). Significant gender differences were observed in MAC and weight (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). The multiple linear regression model (weight\u223cMAC\u2009+\u2009height\u2009+\u2009HS) demonstrated a strong fit (R\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.878). Overall, PW10 was 10.8%, and PW20 was 21.0%, with marked age-dependent variation, with moderate performance in schoolers (PW10: 10.1%, PW20: 22.2%) and the highest in adolescents (PW10: 41.9%, PW20: 81.7%). MAC\u2013HS agreement showed a moderate-to-weak positive association (gamma\u2009=\u20090.226). PCA revealed a single dominant factor explaining 62.4% of variance, with strong loadings for weight (0.89) and MAC (0.85). CFA proxy indices indicated acceptable-to-good model fit (comparative fit index \u223c0.92\u20130.95, standardized root mean square residual \u223c0.06\u20130.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PAWPER XL-MAC scale shows acceptable structure validity in Turkish children but has age-related accuracy issues, especially in younger groups. Age-specific adjustments are recommended to improve reliability for emergency weight estimation and drug dosing in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1915860","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:32:05Z","timestamp":1789536725000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Pediatric Advanced Weight Prediction in the Emergency Room Extra Large Mid-Arm Circumference scale in Turkish children"],"prefix":"10.3389","volume":"14","author":[{"given":"Yesim","family":"Andiran Senayli","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Anesthesiology and Reanimation, Yozgat Bozok University","place":["Yozgat, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevgi","family":"Ulusoy Tangul","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatric Surgery, Yozgat Bozok University","place":["Yozgat, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akif","family":"Demirel","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anesthesiology and Reanimation, Yozgat Bozok University","place":["Yozgat, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atilla","family":"Senayli","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatric Surgery, Yozgat Bozok University","place":["Yozgat, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.7196\/SAMJ.2017.v107i11.12505","article-title":"Development and validation of a method to estimate body weight in critically ill children using length and mid-arm circumference measurements: the PAWPER XL-MAC system","volume":"107","author":"Wells","year":"2017","journal-title":"S Afr Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"166","DOI":"10.7196\/SAMJ.2021.v111i2.15061","article-title":"Are adults just big kids? 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