Background
Methods
Search methods for the identification of publications
Eligibility criteria
Inclusion criteria
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Children/adolescents aged 0–19 years, including 19 year olds (according to WHO classifications of adolescence up to 19 years [9])
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Mothers with their children
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Children, adolescents (aged 0–19 years) and their parents or family
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Health indices combining different health indicators into a composite score
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Health promotion and prevention
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Monitoring of health indicators
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Oral health
Exclusion criteria
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Aged over 19 years
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General population or clinical population
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Indicators from areas other than health
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Indicators on Quality of Life
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Studies with the purpose of examining quality criteria of a diagnostic instrument
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Clinical interventions or clinical settings
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Indicators with a clinical aim such as health care delivery and quality of care
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Association studies and predictors of health indicators
Study selection
Identification of indices
Data extraction, management and synthesis
Quality appraisal of indices
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Consistency: Consistency is defined as “having reliability in measurement, so that variation in values is true variation not random error” [5].
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Sensitivity: Sensitivity examines whether the index is appropriate to assess change over time [5].
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Feasibility: Feasibility means that “reliable source data must be available” [5].
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Defined: An index is defined, when it is “unambiguous in its data construct” [5].
Results
Selection of sources of evidence
Characteristics of sources of evidence
Authors | Year of publication | Study type | Countrya | Setting | Population age (years)b | Indices in this paper |
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Abalkhail & Shawky [13] | 2002 | Observational | Saudi Arabia | Schools | 10–19 | BMI percentiles for age and sex, Mid-arm muscle circumference (MAMC) |
AlBuhairan et al. [14] | 2015 | Observational | Saudi Arabia | Schools | 10–19 | Body Mass Index (BMI), BMI percentiles for age and sex |
Antunes et al. [15] | 2004 | Observational | Brazil | n.a.c | 11–12 | Decayed, missing and filled teeth (DMFT), Significant Caries Index (SiC index) |
Ardic & Erdogan [16] | 2017 | Interventional | Turkey | Schools | 12–15 | Body Mass Index (BMI) |
Austin et al. [17] | 2007 | Interventional | USA | Schools | Grade 6–7 | Body Mass Index (BMI), BMI percentiles for age and sex |
Ayatollahi & Bagheri [18] | 2010 | Observational | Iran | School | 6.5–11.5 | Body Mass Index (BMI) |
Bay et al. [19] | 2017 | Review | n.a. | Schools | n.a. | Body Mass Index (BMI), Waist-to-height ratio |
Beauchamp et al. [20] | 2011 | Interventional | Canada | Schools | Mean age 14.07 | Body Mass Index (BMI), BMI percentiles for age and sex, Waist-to-hip ratio |
Biscaglia et al. [21] | 2019 | Observational | Jordan, Lebanon, Syria, Gaza Strip and West Bank | Schools | 12 | Decayed, missing and filled surfaces (DMFS), Decayed, missing and filled teeth (DMFT), Significant Caries Index (SiC index) |
Detty [22] | 2013 | Observational | USA | Schools | Grade 3 | Body Mass Index (BMI) |
Do & Spencer [23] | 2007 | Observational | Australia | n.r.d | 8–13 | Decayed, missing and filled surfaces (DMFS) |
Elder et al. [24] | 2014 | Interventional | USA | Recreation centres | 5–8 | Body Mass Index (BMI), BMI percentiles for age and sex, BMI z-scores for age and sex |
Flynn et al. [25] | 2006 | Review | n.a. | n.a. | n.a. | Body Mass Index (BMI), BMI percentiles for age and sex |
Gardner et al. [26] | 2016 | Observational | Australia | n.a. | 0–16 | Body Mass Index (BMI) |
Gissler et al. [27] | 1992 | Observational | Finland | n.a. | 0–7 | Ponderal index, 1-min Apgar score, 5-min Apgar score, perinatal health index |
Greer et al. [28] | 2003 | Observational | USA | Schools | 5–9 | Decayed, missing and filled teeth (DMFT) |
Hebestreit [29] | 2019 | Review | Europe | n.a. | n.a. | Body Mass Index (BMI) |
Kilanowski & Lin [30] | 2014 | Interventional | USA | Schools | 11–17 | Body Mass Index (BMI), BMI percentiles for age and sex |
Kilanowski & Ryan-Wenger [31] | 2007 | Observational | USA | n.a. | 0–12 | BMI percentiles for age and sex, decayed, missing and filled teeth (DMFT) |
Kohen et al. [32] | 2007 | Observational | Canada | Schools | 4–11 | Health Utilities Index (HUI) |
Köhler [33] | 2006 | Review | Sweden | n.a. | 0–19 | Health indicators for Swedish children |
Köhler [1] | 2016 | Review | n.a. | n.a. | n.a. | Health indicators for Swedish children |
Koivusilta et al. [34] | 2006 | Observational | Finland | n.a. | 12–16 | Body Mass Index (BMI), BMI percentiles for age and sex |
Kulaga et al. [35] | 2010 | Observational | Poland | Schools | 6.5–18.5 | Body Mass Index (BMI), BMI z-scores for age and sex |
Kuntz & Lampert [36] | 2013 | Observational | Germany | n.a. | 11–17 | Body Mass Index (BMI), BMI percentiles for age and sex, Healthy Lifestyle Index (HLI) |
Muratbegovic et al. [37] | 2010 | Observational | Bosnia and Herzegovina | Communities | 6 | Decayed, missing and filled teeth (DMFT) |
Nyström et al. [38] | 2016 | Observational | Sweden | n.r. | 0–18 | Body Mass Index (BMI) |
Ottolenghi et al. [39] | 2007 | Review | Europe | n.a. | n.a. | Decayed, missing and filled teeth (DMFT) |
Peoples-Sheps et al. [40] | 1998 | Review | USA | n.a. | 1–19 | Body Mass Index (BMI), BMI percentiles for age and sex |
Smadi [41] | 2017 | Observational | Jordan | Schools | 12–18 | Decayed, missing and filled teeth (DMFT), Significant Caries Index (SiC index) |
Stamm [42] | 1980 | Review | Canada, USA | n.a. | n.a. | Decayed, missing and filled teeth (DMFT), deft index (for primary/baby teeth) |
Stamm et al. [43] | 1980 | Observational | Canada | n.a. | 13–14 | Decayed, missing and filled teeth (DMFT), Oral Hygiene Index (simplified) OHI(S) |
Tyler [44] | 2004 | Observational | USA | School based health centre | 7–12 | Body Mass Index (BMI), BMI percentiles for age and sex |
Vogeltanz-Holm & Holm [45] | 2018 | Interventional | USA | Schools | Mean age 8.75 | Body Mass Index (BMI), BMI percentiles for age and sex, BMI z-scores for age and sex |
Whittemore et al. [46] | 2013 | Interventional | USA | Schools | 14–17 | Body Mass Index (BMI), BMI percentiles for age and sex |
Wrobel & Mielnik-Blaszczak [47] | 2012 | Interventional | Poland | Schools | 12–13 | Decayed, missing and filled surfaces (DMFS) |
Health indices with quality assessment
Categories | Index | Variables included in the index | Referencesa |
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Anthropometrical | Body Mass Index (BMI) | Height, weight | Abalkhail & Shawky, 2002 [13]; AlBuhairan et al. 2015 [14]; Ardic & Erdogan, 2017 [16]; Austin et al., 2007 [17]; Ayatollahi & Bagheri, 2010 [18]; Bay et al., 2017 [19]; Beauchamp et al., 2011 [20]; Detty, 2013 [22]; Elder et al., 2014 [24]; Flynn et al., 2006 [25]; Gardner et al., 2016 [26]; Hebestreit, 2019 [29]; Kilanowski & Lin, 2014 [30]; Koivusilta et al., 2006 [34]; Kulaga et al., 2010 [35]; Kuntz & Lampert, 2013 [36]; Nyström et al., 2016 [38]; Peoples-Sheps et al., 1998 [40]; Tyler, 2004 [44], Vogeltanz-Holm & Holm, 2018 [45]; Whittemore et al.,2013 [46] |
Anthropometrical | BMI percentiles for age and sex | Height, weight | Abalkhail & Shawky, 2002 [13]; AlBuhairan et al. 2015 [14]; Austin et al., 2007 [17]; Beauchamp et al., 2011 [20]; Elder et al., 2014 [24]; Flynn et al., 2006 [25]; Kilanowski & Lin, 2014 [30]; Kilanowski & Ryan-Wenger, 2007 [31]; Koivusilta et al., 2006 [34]; Kuntz & Lampert, 2013 [36]; Peoples-Sheps et al., 1998 [40]; Tyler, 2004 [44]; Vogeltanz-Holm & Holm, 2018 [45]; Whittemore et al.,2013 [46] |
Anthropometrical | BMI z-scores for age and sex | Height, weight | |
Anthropometrical | Waist-to-height ratio | Height, waist circumference | Bay et al., 2017 [19] |
Anthropometrical | Waist-to-hip ratio | Waist circumference, hip circumference | Beauchamp et al., 2011 [20] |
Anthropometrical | Mid-arm muscle circumference (MAMC) | Mid-arm circumference, triceps skin fold thickness | Abalkhail & Shawky, 2002 [13] |
Anthropometrical | Ponderal index | Weight, height | Gissler et al., 1999 [27] |
Newborns | 1-min Apgar score | Appearance (skin colour), pulse (heart rate), grimace response (reflexes), activity (muscle tone), respiration (breathing rate and effort) | Gissler et al., 1999 [27] |
Newborns | 5-min Apgar score | Appearance (skin colour), pulse (heart rate), grimace response (reflexes), activity (muscle tone), respiration (breathing rate and effort) | Gissler et al., 1999 [27] |
Newborns | Perinatal health index | Birthweight, gestational age, 5-min Apgar score, birthweight by gestational age, perinatal diagnosis | Gissler et al., 1999 [27] |
Dental | Decayed, missing and filled surfaces (DMFS) | Decayed surfaces (DS), missing surfaces (MS), filled surfaces (FS) | |
Dental | Decayed, missing and filled teeth (DMFT) | Decayed teeth (DT), missing teeth (MT), filled teeth (FT) | |
Dental | Significant Caries Index (SiC index) | Decayed teeth/ surfaces (DT/S), missing teeth/surfaces (MT/S), filled teeth/surfaces (FT/S) | |
Dental | Deft index (for primary/baby teeth) | Decayed teeth, teeth extracted due to caries, filled teeth | Stamm, 1980 [42] |
Dental | Oral Hygiene Index (simplified) OHI(S) | Debris score, calculus score | Stamm et al., 1980 [43] |
Lifestyle | Healthy Lifestyle Index (HLI) | Current tobacco consumption, body mass index, physical activity, regular consumption of alcohol, consumption of fresh fruit and vegetables, daily use of electronic media: television/video, computer/internet and game console | Kuntz & Lampert, 2013 [36] |
Functional ability | Health Utilities Index (HUI) | Vision, hearing, speech, ambulation, dexterity, cognition, emotion, pain | Kohen et al., 2007 [32] |
Combination of different aspects | Health indicators for Swedish children | Children injured by external causes, children exposed to tobacco in the womb, children with low birthweight, children that are breastfed, teenage abortions, children vaccinated against MPR (measles, parotitis and rubella) |
Index | Face validitya | Face validityb | Construct validitya | Construct validityb | Consistencya | Consistencyb | Sensitivitya | Sensitivityb | Feasibility | Defined |
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Body Mass Index (BMI) | Yes | Yes [48] | Yes | Yes | Discussed | Yes | Yes | Yes | Primary data | Yes [48] |
BMI percentiles for age and sex | Yes | Yes [48] | Yes | Yes | Yes | Yes | Yes | Yes | Primary data | Yes [48] |
BMI z-scores for age and sex | Yes | Yes [48] | Yes | Yes | Yes | Yes | Yes | Yes | Primary data | Yes [48] |
Waist-to-height ratio | Yes | Yes | Yes | Yes | Yes | Yes [49] | Yes | Yes [49] | Primary data | |
Waist-to-hip ratio | Yes | Yes [52] | Yes | Yes | Yes | Yes [52] | Yes | Yes [52] | Primary data | Yes [52] |
Mid-arm muscle circumference (MAMC) | Yes | Yes | Yes | Yes | Yes | Yes | n.a.c | n.r.d | Primary data | Yes [13] |
Ponderal index | Yes | Yes [53] | Yes | Yes [53] | Yes | Yes [53] | Yes | Yes [53] | Primary data | Yes [27] |
1-min Apgar score | Yes | Yes [54] | n.a. | n.r. | No | No [54] | n.a. | n.r. | Routine data | Yes [54] |
5-min Apgar score | Yes | Yes [54] | n.a. | n.r. | No | No [54] | n.a. | n.r. | Routine data | Yes [54] |
Perinatal health index | Yes | n.r. | n.a. | n.r. | Discussed | Yes | No | No | Routine data | Yes |
Decayed, missing and filled surfaces (DMFS) | Yes | Yes [55] | Yes | Yes | Yes | Yes | Yes | Yes [55] | Primary data, routine data | Yes |
Decayed, missing and filled teeth (DMFT) | Yes | Yes [55] | Yes | Yes | Yes | Yes | Yes | Yes [55] | Primary data | Yes |
Significant Caries Index (SIC index) | Yes | Yes [55] | Yes | Yes | Yes | Yes | Yes | Yes [55] | Primary data | Yes |
Deft index (for primary/baby teeth) | Yes | Yes [55] | Yes | Yes | Yes | Yes | Yes | Yes | Primary data | Yes |
Oral Hygiene Index (simplified) OHI(S) | n.a. | n.r. | n.a. | n.r. | Yes | Yes | Yes | Yes | Primary date | Yes |
Healthy Lifestyle Index (HLI) | Discussed | Discussed | Yes | Yes | Discussed | n.r. | No | No | Primary data | Yes |
Health Utilities Index (HUI) | Yes | Yes [56] | n.a. | n.r. | Discussed | Yes [56] | Yes | Yes [56] | Primary data | Yes |
Health indicators for Swedish children | No | No | n.a. | n.r. | Yes | Yes | Yes | Yes | Routine data | Yes |