MUAC and WHZ and mortality.

Mark,

Community data of untreated children are best to assess the respective value of MUAC vs WFH to assess the risk of death and need for treatment. Hospital data are a second choice. They can provide useful information however provided a MUAC or WFH based criterion is not used predominantly as admission criterion, which would lead to a truncated sample and would distort the results. Apparently there was no selection bias with MUAC or WFH in the study you quote which is based on an unselected sample of sick children. See this from the methods section:

“All consecutive children, aged 6 months to 5 years admitted to the paediatric emergency department during the study period from February 2012 to March 2013, were considered eligible for recruitment”.

This paper is yet another one showing that MUAC has a ROC curve clearly above that of WFH to predict death, suggesting that MUAC is better than WFH to identify high risk children in the Indian subcontinent as well. This is also consistent with 2 previous community studies in Bangladesh which showed the same thing. It reinforces the point that low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment