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edit standardisation chapter; fix #17 #32

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88 changes: 41 additions & 47 deletions 06-standardisation.qmd
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Original file line number Diff line number Diff line change
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# Anthropometric measurement standardisation test {#sec-standardisation-test}

The survey personnel should go through theoretical discussions and demonstrations on how to perform the anthropometric measurements. This should then be followed by practical demonstration of the measurement techniques, measurement readings and recording ideally with a large number of children particularly if there is a large number of survey personnel. Once all personnel have had the opportunity to adequately practice their measurement and recording techniques, a standardisation test or exercise must be carried out. Chapter \@ref(standard) provides detailed instructions on how to carry out an anthropometric measurement standardisation test as part of a training process in preparation for a nutrition survey.
The survey personnel should go through theoretical discussions and demonstrations on how to perform the anthropometric measurements. This should then be followed by practical demonstration of the measurement techniques, measurement readings and recording ideally with a large number of children particularly if there is a large number of survey personnel. Once all personnel have had the opportunity to adequately practice their measurement and recording techniques, a standardisation test or exercise must be carried out. This chapter provides detailed instructions on how to carry out an anthropometric measurement standardisation test as part of a training process in preparation for a nutrition survey.

## Objectives
## Objectives {#sec-standardisation-test-objectives}

The standardisation test evaluates the **precision** and the **accuracy** of the measurements taken by each survey personnel.

The **accuracy** of measurements taken by survey personnel is determined by how close they are to the true value with repeated measurements. On the other hand, the **precision** of measurements taken by survey personnel is determined by how similar the values are of repeated measurements made. In preparation for a nutrition survey while the survey personnel are in training, the aim is for survey personnel to be *highly accurate* and *highly precise* with their anthropometric measurements.

```{r standard01, fig.cap = "Relationship between accuracy and precision", echo = FALSE, fig.align = "center", fig.retina = 1}
knitr::include_graphics("images/accuracyPrecision.png")
```
![Relationship between accuracy and precision](images/accuracyPrecision.png){#fig-accuracy-precision fig-align="center"}

## Mechanics
## Mechanics {#sec-standardisation-test-mechanics}

The general process of the standardisation test is for each survey personnel to take measurements of at least 10 children 6-59 months, twice, with an interval of time between the 1st and 2nd measurements.

### Test parameters
### Test parameters {#sec-standardisation-test-parameters}

The following test parameters need to be followed when conducting an anthropometric standardisation test:

Expand All @@ -30,8 +28,7 @@ The following test parameters need to be followed when conducting an anthropomet

5. Survey personnel measurements are compared to the repeated measures taken (intra-observer)


### Test organisation and requirements
### Test organisation and requirements {#sec-standardisation-test-requirements}

The following test organisation and requirements need to be met in order to conduct a credible standardisation test:

Expand All @@ -45,7 +42,7 @@ The following test organisation and requirements need to be met in order to cond

4. There should only be one pair of survey personnel per child at any time during the test

5. Each survey personnel is given a unique ID. For example if there are 20 survey personnel, a unique ID from 1 to 20 is given to each survey personnel. The supervisor’s ID is always 0
5. Each survey personnel is given a unique ID. For example if there are 20 survey personnel, a unique ID from 1 to 20 is given to each survey personnel. The supervisor’s ID is always 0.

6. Each measurement station should have a height board, weighing scale and a MUAC tape

Expand All @@ -54,7 +51,7 @@ The following test organisation and requirements need to be met in order to cond
8. It is not allowed for pairs of survey personnel to speak with other pairs during the test


### Timeframe
### Timeframe {#sec-standardisation-test-timeframe}

In order to follow the test parameters specified above and organise the test appropriately, a considerable amount of time needs to be set aside for conducting the test.

Expand All @@ -64,42 +61,45 @@ It would be possible to have a different set of 10 children for the afternoon se

For larger scale surveys with survey personnel more than 20, more days will be required to conduct the test to appropriately and to correct specifications.


### Steps in carrying out the standardisation test
### Steps in carrying out the standardisation test {#sec-standardisation-test-steps}

1. The supervisor carefully performs the measurements on each child without allowing the teams to see the values. The supervisor records his/her measurements on the standardisation test form for the first round of measurements.

<p style="text-align: centre;">Standardisation Test Form - Measurement Round 1</p>

Enumerator ID: _____ &nbsp; &nbsp; &nbsp; Enumerator Name: ___________________

+--------------------+--------------------+--------------------+--------------------+--------------------+
| Child ID | Weight (kg) | Height (cm) | MUAC (mm) | Oedema (yes/no) |
+====================+====================+====================+====================+====================+
| 01 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 02 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 03 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 04 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 05 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 06 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 07 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 08 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 09 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
| 10 | | | | |
+--------------------+--------------------+--------------------+--------------------+--------------------+
::: {#tbl-standardisation-test-form}

+----------+-------------+-------------+-----------+-----------------+
| Child ID | Weight (kg) | Height (cm) | MUAC (mm) | Oedema (yes/no) |
+==========+=============+=============+===========+=================+
| 01 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 02 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 03 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 04 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 05 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 06 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 07 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 08 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 09 | | | | |
+----------+-------------+-------------+-----------+-----------------+
| 10 | | | | |
+----------+-------------+-------------+-----------+-----------------+

Example of a standardisation test form

:::

::: {.callout-note .column-margin}

Download the standardisation test form [here](pdf/standardForm.pdf).
## Download

Sample standardisation test form - [PDF](pdf/standardForm.pdf)

:::

Expand All @@ -111,9 +111,3 @@ Download the standardisation test form [here](pdf/standardForm.pdf).

5. After the lunch break or on a new day altogether, the whole process is done all over again but this time, the second half of the teams will be performing the measurements. Ideally, the same set of mother and child pairs should be utilised for the second half day of testing. However, it may be that some of the mothers will be unable to come back to help. If for the second half day of testing the mother and child pairs are different from the first half day, then measurements made in the second half day cannot be mixed with the data from the first half day when reporting on the performance in the standardisation test of the survey personnel.







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