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Automatic WHZ calculation in excel database

This question was posted the Assessment and Surveillance forum area and has 6 replies.

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Niederberger, Nicole

Normal user

29 Oct 2018, 19:34

I would like to introduce a automatic calculation of WHZ in a CMAM program patient database where I have the needed variables (gender, length/height and weight). Does anyone know whether there is a standardised way to do that? Thanks for the feedback

Tariq Khan

Normal user

2 Nov 2018, 06:47

I remember I was using an excel sheet to calculate the WHZ in one of my research study at graduate level. I used the reference weight for a range of specific height from the publication of A. Roberto Frisancho .

I would have to sort out my data by the heights (Ascending or descending) and input the reference weight and use a formula of Z-score (Actual weight - Reference Weight / Standard Deviation) which would determine the WHZ in a separate column.

You can get the reference weight and SD from the same source for every specific range of heights. The publication has also classified reference weight and height based on age.

In order to create an automated WHZ sheet, you need to apply a condition on the height column and define the reference weights and SD in that condition.

However, it is worth mentioning here, we always use WHO references for the CMAM activities. I have never seen any such classification of references based on age and height in WHO's publications unless they have a new publication which I am not aware of.

Hope this answers your question.

Niederberger, Nicole

Normal user

4 Nov 2018, 15:14

Thank you Tarik Kahn. Yes, your answer gives me additional understanding.

Blessing Mureverwi


Normal user

4 Nov 2018, 16:08

Just curious to find out why one would want to do this given that ENA is easy to use for such things.

Carlos Grijalva-Eternod

UCL Institute for Global Health

Normal user

5 Nov 2018, 13:29

Hi Nicole,

I would advise againts following Tariq's suggestion for z-score calculation, as the 2006 WHO Growth Standards use the LMS method for the generation of z-scores, as to correct for the fact that anthropometric data is never normally distributed. By using the formula (observed value - mean reference value / standard deviation of the given length/height distribution) you will be generating incorrect z-scores that would affect your CMAM programming.

Anonymous 730 has correctly suggested the use of ENA software, but if you need your data to be in an excel database, you will need to use the ENA software to export it into that format and copy it into your database.

An alternative method would be to use the LMSgrowth excel add-in that would allow you to generate the z-score values, using the 2006 WHO growth standards, directly into your excel database. The convenience of using this add-in is that your database can be automated to calculate z-scores following data inputation; and the add-in can be use in a Windows or Mac OS environment, which if remember correctly, is an ENA software limitation.

I hope the above is useful.

Niederberger, Nicole

Normal user

6 Nov 2018, 20:01

Hi Carlos,
Your explanation makes sense.
Indeed, I used the ENA software so far but was looking for way that would be more convenient for our data manager to use. I will try that excel ad in.
Thanks a lot



Normal user

7 Sep 2023, 15:39

I am curious if there has been any developments in this area, since these replies? I also thought that a way to do it in excel is a good way to combine other data, well suited to excel, with the Z scirrs

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