Journal of Clinical Epidemiology
Volume 63, Issue 6 , Pages 655-659, June 2010

Pictogram use was validated for estimating individual's body mass index

  • Abbas Ali Keshtkar

      Affiliations

    • Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  • ,
  • Shahryar Semnani

      Affiliations

    • Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  • ,
  • Akram Pourshams

      Affiliations

    • Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • ,
  • Hooman Khademi

      Affiliations

    • Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • ,
  • Gholamreza Roshandel

      Affiliations

    • Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
    • Corresponding Author InformationCorresponding author. Number 77, Qabooseieh Passage, Valiasr Street, Gorgan 49166-53588, Golestan Province, Iran. Tel.: +98-171-2240835; fax: +98-171-2269210.
  • ,
  • Paolo Boffetta

      Affiliations

    • Genetics and Epidemiology Cluster, International Agency for Research on Cancer, Lyon, France
  • ,
  • Reza Malekzadeh

      Affiliations

    • Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran

Accepted 11 August 2009. published online 13 November 2009.

Abstract 

Objective

We designed this study to assess the validity and reliability of pictogram for estimating body mass index (BMI).

Study Design and Setting

Participants of Golestan cohort study during 2000–2004 were recruited in this study. Demographic and anthropometric information (weight, height, and BMI) were collected on all participants. A set of drawings (pictogram) ranging from very lean to obese were used to assess the individual's perception of their body size. Sensitivity and specificity of each pictogram score were calculated and cutoff points were determined using sensitivity/specificity plots. We used receiver operating characteristic curves to assess the validity of pictogram scores.

Results

Of the 15,437 subjects enrolled in the study, 6,574 (42.6%) were males and 8,863 (57.4%) were females. Their mean±standard deviation age was 52.58±9.28 years. Pictogram scores 1, 2, and 3 were assigned to normal participants; pictogram score 4 was selected by overweight subjects, and finally, pictogram scores equal or higher than 5 were selected by obese ones (area under curve: 0.83–0.85).

Conclusion

According to our results, pictogram is a valid measure for discriminating obese or overweight from normal individuals, and for distinguishing obese from overweight or normal individuals. So it can be concluded that body image pictogram is valid for discriminating normal and obese individuals.

Keywords: Body mass index, Pictogram, Estimation, Validity, Sensitivity, Specificity

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PII: S0895-4356(09)00266-2

doi:10.1016/j.jclinepi.2009.08.014

Journal of Clinical Epidemiology
Volume 63, Issue 6 , Pages 655-659, June 2010