Construction of the World Health Organization child growth standards: Selection of methods for attained growth curves

Elaine Borghi, Mercedes de Onis, Cutberto Garza, Jan Van den Broeck, Edward A. Frongillo, Laurence Grummer-Strawn, S. Van Buuren, H. Pan, L. Molinari, Reynaldo Martorell, Adelheid W. Onyango, Jose C. Martines, Alain Pinol, Amani Siyam, Cesar G. Victoria, Maharaj K. Bhan, Cora Luiza Araújo, Anna Lartey, William B. Owusu, Nita BhandariKaare R. Norum, Gunn Elin Aa Bjoerneboe, Ali Jaffer Mohamed, Kathryn G. Dewey, Krishna Belbase, Cameron Chumlea, Tim Cole, Roger Shrimpton, Elaine Albernaz, Elaine Tomasi, Rita de Cássia Fossati da Silveira, Gisele Nader, Isabella Sagoe-Moses, Veronica Gomez, Charles Sagoe-Moses, Sunita Taneja, Temsunaro Rongsen, Jyotsna Chetia, Pooja Sharma, Rajiv Bahl, Anne Baerug, Elisabeth Tufte, Deena Alasfoor, Nitya S. Prakash, Ruth M. Mabry, Hanadi Jamaan Al Rajab, Sahar Abdou Helmi, Laurie A. Nommsen-Rivers, Roberta J. Cohen, M. Jane Heinig

Research output: Contribution to journalArticlepeer-review

203 Scopus citations


The World Health Organization (WHO), in collaboration with a number of research institutions worldwide, is developing new child growth standards. As part of a broad consultative process for selecting the best statistical methods, WHO convened a group of statisticians and child growth experts to review available methods, develop a strategy for assessing their strengths and weaknesses, and discuss methodological issues likely to be faced in the process of constructing the new growth curves. To select the method(s) to be used, the group proposed a two-stage decision-making process. First, to select a few relevant methods based on a list of set criteria and, second, to compare the methods using available tests or other established procedures. The group reviewed 30 methods for attained growth curves. Using the pre-defined criteria, a few were selected combining five distributions and two smoothing techniques. Because the number of selected methods was considered too large to be fully tested, a preliminary study was recommended to evaluate goodness of fit of the five distributions. Methods based on distributions with poor performance will be eliminated and the remaining methods fully tested and compared.

Original languageEnglish (US)
Pages (from-to)247-265
Number of pages19
JournalStatistics in Medicine
Issue number2
StatePublished - Jan 30 2006
Externally publishedYes


  • Child growth
  • Growth curves
  • Kurtosis
  • Skewness
  • Smoothing
  • Standards

ASJC Scopus subject areas

  • Epidemiology


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