Measurement of head circumference using a smartphone - feasibility study (Preprint)

Abstract

Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to error, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner differences in tape measure placement and tautness. There is, therefore, the need for a more reliable method.

The main objective of this study was to evaluate the feasibility of the app in a clinical setting and gain clinically relevant feedback from the users to develop the technology further and test usability by both health care professionals and parents/guardians.

We recruited infants presenting to the neurosurgery clinic, where parents/guardians were approached and consented to the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app(HC app) developed in-house, and we also collected baseline medical history and characteristics. COSMIN principles were used to define measurement reliability, validity and reproducibility to compare novel technology measures, and statistical analysis was done in R studio. Our main objective was to compare means between measurements. We used the measurements taken by the HC app to analyse covariance and interclass correlation coefficient to compare the measurement's within-rater and inter-rater reliability. F-test was used to analyse variance between sizes and Cohen’s Kappa to compare the Tape measurement to the measures taken by the HC app and t.test and correlation coefficients.

The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability with ICC 0.177 and wide within-app variations (ICC 0.341). The agreement between the parent/guardian and the researcher measurements with tape measure were good with ICC- 0.901. Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (86%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality.

We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by the parents/guardians in their own homes.

ClinicalTrials.gov -NCT05762848, https://classic.clinicaltrials.gov/ct2/show/results/NCT05762848?view=results