ROC Generated Thresholds for Field-Assessed Aerobic Fitness Related to Body Size and Cardiometabolic Risk in Schoolchildren

Lynne Boddy, Non E. Thomas, Stuart Fairclough, Keith Tolfrey, Sinead Brophy, Anwen Rees, Gareth Knox, Julien Baker, Gareth Stratton

Research output: Contribution to journalJournal Article

21 Citations (Scopus)

Abstract

Objectives: 1. to investigate whether 20 m multi-stage shuttle run performance (20mSRT), an indirect measure of aerobic fitness, could discriminate between healthy and overweight status in 9–10.9 yr old schoolchildren using Receiver Operating Characteristic (ROC) analysis; 2. Investigate if cardiometabolic risk differed by aerobic fitness group by applying the ROC cut point to a second, cross-sectional cohort.
Design: Analysis of cross-sectional data.
Participants: 16,619 9–10.9 year old participants from SportsLinx project and 300 11–13.9 year old participants from the Welsh Schools Health and Fitness Study.
Outcome Measures: SportsLinx; 20mSRT, body mass index (BMI), waist circumference, subscapular and superilliac skinfold thicknesses. Welsh Schools Health and Fitness Study; 20mSRT performance, waist circumference, and clustered cardiometabolic risk.
Analyses: Three ROC curve analyses were completed, each using 20mSRT performance with ROC curve 1 related to BMI, curve 2 was related to waist circumference and 3 was related to skinfolds (estimated % body fat). These were repeated for both girls and boys. The mean of the three aerobic fitness thresholds was retained for analysis. The thresholds were subsequently applied to clustered cardiometabolic risk data from the Welsh Schools study to assess whether risk differed by
aerobic fitness group.
Results: The diagnostic accuracy of the ROC generated thresholds was higher than would be expected by chance (all models AUC .0.7). The mean thresholds were 33 and 25 shuttles for boys and girls respectively. Participants classified as ‘fit’ had significantly lower cardiometabolic risk scores in comparison to those classed as unfit (p,0.001).
Conclusion: The use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for ‘‘at-risk’’ children to be referred onto intervention services.
Original languageEnglish
Number of pages5
JournalPLoS One
Volume7
Issue number9
DOIs
Publication statusPublished - 21 Sep 2012

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school children
Body Size
ROC Curve
body size
waist circumference
Waist Circumference
School Health Services
Health
body mass index
Body Mass Index
Skinfold Thickness
skinfold thickness
health care workers
teachers
cross-sectional studies
body fat
Area Under Curve
Adipose Tissue
Cross-Sectional Studies
Fats

Cite this

Boddy, Lynne ; Thomas, Non E. ; Fairclough, Stuart ; Tolfrey, Keith ; Brophy, Sinead ; Rees, Anwen ; Knox, Gareth ; Baker, Julien ; Stratton, Gareth. / ROC Generated Thresholds for Field-Assessed Aerobic Fitness Related to Body Size and Cardiometabolic Risk in Schoolchildren. In: PLoS One. 2012 ; Vol. 7, No. 9.
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abstract = "Objectives: 1. to investigate whether 20 m multi-stage shuttle run performance (20mSRT), an indirect measure of aerobic fitness, could discriminate between healthy and overweight status in 9–10.9 yr old schoolchildren using Receiver Operating Characteristic (ROC) analysis; 2. Investigate if cardiometabolic risk differed by aerobic fitness group by applying the ROC cut point to a second, cross-sectional cohort.Design: Analysis of cross-sectional data.Participants: 16,619 9–10.9 year old participants from SportsLinx project and 300 11–13.9 year old participants from the Welsh Schools Health and Fitness Study.Outcome Measures: SportsLinx; 20mSRT, body mass index (BMI), waist circumference, subscapular and superilliac skinfold thicknesses. Welsh Schools Health and Fitness Study; 20mSRT performance, waist circumference, and clustered cardiometabolic risk.Analyses: Three ROC curve analyses were completed, each using 20mSRT performance with ROC curve 1 related to BMI, curve 2 was related to waist circumference and 3 was related to skinfolds (estimated {\%} body fat). These were repeated for both girls and boys. The mean of the three aerobic fitness thresholds was retained for analysis. The thresholds were subsequently applied to clustered cardiometabolic risk data from the Welsh Schools study to assess whether risk differed byaerobic fitness group.Results: The diagnostic accuracy of the ROC generated thresholds was higher than would be expected by chance (all models AUC .0.7). The mean thresholds were 33 and 25 shuttles for boys and girls respectively. Participants classified as ‘fit’ had significantly lower cardiometabolic risk scores in comparison to those classed as unfit (p,0.001).Conclusion: The use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for ‘‘at-risk’’ children to be referred onto intervention services.",
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ROC Generated Thresholds for Field-Assessed Aerobic Fitness Related to Body Size and Cardiometabolic Risk in Schoolchildren. / Boddy, Lynne; Thomas, Non E.; Fairclough, Stuart; Tolfrey, Keith; Brophy, Sinead; Rees, Anwen; Knox, Gareth; Baker, Julien; Stratton, Gareth.

In: PLoS One, Vol. 7, No. 9, 21.09.2012.

Research output: Contribution to journalJournal Article

TY - JOUR

T1 - ROC Generated Thresholds for Field-Assessed Aerobic Fitness Related to Body Size and Cardiometabolic Risk in Schoolchildren

AU - Boddy, Lynne

AU - Thomas, Non E.

AU - Fairclough, Stuart

AU - Tolfrey, Keith

AU - Brophy, Sinead

AU - Rees, Anwen

AU - Knox, Gareth

AU - Baker, Julien

AU - Stratton, Gareth

PY - 2012/9/21

Y1 - 2012/9/21

N2 - Objectives: 1. to investigate whether 20 m multi-stage shuttle run performance (20mSRT), an indirect measure of aerobic fitness, could discriminate between healthy and overweight status in 9–10.9 yr old schoolchildren using Receiver Operating Characteristic (ROC) analysis; 2. Investigate if cardiometabolic risk differed by aerobic fitness group by applying the ROC cut point to a second, cross-sectional cohort.Design: Analysis of cross-sectional data.Participants: 16,619 9–10.9 year old participants from SportsLinx project and 300 11–13.9 year old participants from the Welsh Schools Health and Fitness Study.Outcome Measures: SportsLinx; 20mSRT, body mass index (BMI), waist circumference, subscapular and superilliac skinfold thicknesses. Welsh Schools Health and Fitness Study; 20mSRT performance, waist circumference, and clustered cardiometabolic risk.Analyses: Three ROC curve analyses were completed, each using 20mSRT performance with ROC curve 1 related to BMI, curve 2 was related to waist circumference and 3 was related to skinfolds (estimated % body fat). These were repeated for both girls and boys. The mean of the three aerobic fitness thresholds was retained for analysis. The thresholds were subsequently applied to clustered cardiometabolic risk data from the Welsh Schools study to assess whether risk differed byaerobic fitness group.Results: The diagnostic accuracy of the ROC generated thresholds was higher than would be expected by chance (all models AUC .0.7). The mean thresholds were 33 and 25 shuttles for boys and girls respectively. Participants classified as ‘fit’ had significantly lower cardiometabolic risk scores in comparison to those classed as unfit (p,0.001).Conclusion: The use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for ‘‘at-risk’’ children to be referred onto intervention services.

AB - Objectives: 1. to investigate whether 20 m multi-stage shuttle run performance (20mSRT), an indirect measure of aerobic fitness, could discriminate between healthy and overweight status in 9–10.9 yr old schoolchildren using Receiver Operating Characteristic (ROC) analysis; 2. Investigate if cardiometabolic risk differed by aerobic fitness group by applying the ROC cut point to a second, cross-sectional cohort.Design: Analysis of cross-sectional data.Participants: 16,619 9–10.9 year old participants from SportsLinx project and 300 11–13.9 year old participants from the Welsh Schools Health and Fitness Study.Outcome Measures: SportsLinx; 20mSRT, body mass index (BMI), waist circumference, subscapular and superilliac skinfold thicknesses. Welsh Schools Health and Fitness Study; 20mSRT performance, waist circumference, and clustered cardiometabolic risk.Analyses: Three ROC curve analyses were completed, each using 20mSRT performance with ROC curve 1 related to BMI, curve 2 was related to waist circumference and 3 was related to skinfolds (estimated % body fat). These were repeated for both girls and boys. The mean of the three aerobic fitness thresholds was retained for analysis. The thresholds were subsequently applied to clustered cardiometabolic risk data from the Welsh Schools study to assess whether risk differed byaerobic fitness group.Results: The diagnostic accuracy of the ROC generated thresholds was higher than would be expected by chance (all models AUC .0.7). The mean thresholds were 33 and 25 shuttles for boys and girls respectively. Participants classified as ‘fit’ had significantly lower cardiometabolic risk scores in comparison to those classed as unfit (p,0.001).Conclusion: The use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for ‘‘at-risk’’ children to be referred onto intervention services.

U2 - 10.1371/journal.pone.0045755

DO - 10.1371/journal.pone.0045755

M3 - Journal Article

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 9

ER -