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simpar1471 committed Jan 17, 2025
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7 changes: 5 additions & 2 deletions R/growth_classify.R
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Expand Up @@ -215,7 +215,8 @@ classify_svn <- function(.data,
#' gest_days = gestage,
#' sex = sex)
#' @seealso See [classify_growth()] to run this analysis and others at the same
#' time.
#' time. See [gigs_waz()] to learn which growth standard will be used for
#' different combinations of gestational/chronological age.
#' @export
classify_stunting <- function(
.data,
Expand Down Expand Up @@ -537,13 +538,15 @@ classify_headsize <- function(.data,
#' @note For size-for-GA and small vulnerable newborn analyses, centiles and
#' categorisations will only be applied for birth measurements. These are
#' considered to be the observation per level of `id` where `age_days` is
#' smallest, provided that `age_days` is between `<3`.
#' smallest, provided that `age_days` is `<3`.
#'
#' Categorical (factor) columns produced here may contain unused factor
#' levels. By default, gigs will inform you if these columns have unused
#' factor levels. You can change this behaviour using the
#' [GIGS package-level option][gigs_options]
#' `.gigs_options$handle_unused_levels`.
#' @seealso See [gigs_waz()] to learn which growth standard will be used for
#' different combinations of gestational/chronological age.
#' @examples
#' # This dummy dataset contains data from two people, from birth (<3 days) to
#' # 500 days of age.
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6 changes: 5 additions & 1 deletion man/classify_growth.Rd

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78 changes: 41 additions & 37 deletions paper/paper.md
Original file line number Diff line number Diff line change
@@ -1,6 +1,6 @@
---
title: |
'gigs: A package for standardising fetal, neonatal, and child growth assessment'
`gigs: A package for standardising fetal, neonatal, and child growth assessment`
tags:
- R
- intergrowth
Expand All @@ -19,37 +19,32 @@ authors:
affiliation: '1'
affiliations:
- index: 1
name: Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
name: Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
ror: 00a0jsq62
- index: 2
name: Ariadne Labs, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, U.S.A.
name: Ariadne Labs, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
ror: 03vek6s52

date: 14 December 2024
date: 10 January 2024
bibliography: paper.bib
---

# Summary

Researchers studying newborn and child growth often want to assess how the size
of infants relative to their peers. To do this, researchers can use a growth
standard. A growth standard describes how infants *should* grow if provided
with the nutrition and support required to reach their growth potential.
``gigs`` makes a range of growth standards available in one R package:
the INTERGROWTH-21^st^ Fetal Standards
[@Papageorghiou2014AInternationalPregnancy; @Stirnemann2017InternationalProject;
@Papageorghiou2016InternationalCountries;
@Papageorghiou2014BInternationalPregnancy;
@Drukker2020InternationalProject; @Rodriguez-Sibaja2021FetalProject;
@Stirnemann2020IntergrowthWeight]; INTERGROWTH-21^st^ Newborn Size
and Very Preterm Newborn Size Standards [@Villar2014InternationalProject;
@Villar2016INTERGROWTH-21stCharts; @Villar2017BodyProject]; INTERGROWTH-21^st^ Postnatal Growth
of Preterm Infants Standards [@Villar2015PostnatalProject]; and the WHO Child Growth Standards
[@WHOMulticentreGrowthReferenceStudyGroup2006WHOAge; @WHO2006WHODevelopment;
@WHO2007WHODevelopment]. Also included are functions to classify growth for
indicators including size-for-gestational age, small vulnerable newborns
[@Ashorn2023SmallImpact; @Lawn2023SmallCounting], stunting, wasting,
weight-for-age (underweight), and micro/macrocephaly.
There is a gap for clear guidance and open access tools for assessing nutrition
and growth indicators as part of individual clinical care and population-based
epidemiology. To enable better identification of at-risk infants, a unifying
framework and clear guidance for how, when and for whom to use the existing
international newborn and child growth standards developed by the WHO and
INTERGROWTH-21^st^ is needed. Such guidance is essential to enable tracking of
progress towards Sustainable Development Goals and the WHO Global
Nutrition targets. This need is the motivation for ``gigs`` - a package for
researchers and policymakers that facilitates the appropriate use of growth
standards for the determination and assessment of growth outcomes at the
population level (e.g. stunting, wasting, underweight and trajectories over
time) among vulnerable infants. For clinicians, the ``gigs`` also provides
support in choosing which standards to use when assessing growth of individual
infants.

# Statement of need

Expand All @@ -66,14 +61,13 @@ and local goals. Similarly, use of appropriate standards by clinicians will
enable proper identification of at-risk infants and inform the clinical care
management and decision-making.

Applying appropriate growth standards can be difficult - not all
research groups have the ability to implement growth standards in software, and
may make errors whilst doing so. Furthermore, researchers must pick and choose
the right growth standards for their work - which is not always achieved in
practice [@perumal_who_2015]. The ``gigs`` package makes these issues less
common. Firstly, extensive unit testing ensures that each growth standard in
``gigs`` is accurate to published charts, for every growth standard we've
implemented:
Applying appropriate growth standards can be difficult - not all research groups
have the ability to implement growth standards in software, and may make errors
whilst doing so. Furthermore, researchers must pick and choose the right growth
standards for their work - which is not always achieved in practice
[@perumal_who_2015]. The ``gigs`` package makes these issues less common.
Firstly, extensive unit testing ensures that each growth standard in ``gigs`` is
accurate to published charts, for every growth standard we've implemented:

- The INTERGROWTH-21^st^ Fetal Standards
[@Papageorghiou2014AInternationalPregnancy; @Stirnemann2017InternationalProject;
Expand All @@ -99,6 +93,17 @@ Stata [@vidmar_standardizing_2013], and the R packages ``anthro`` [@r_anthro],
However, only ``gigs`` implements the full set of INTERGROWTH-21^st^ Fetal
standards and INTERGROWTH-21^st^ Postnatal Growth of Preterm Infants standards.

Next, ``gigs`` offers specific functions (``classify_growth()``, ``gigs_waz()``,
and friends) which select an appropriate growth standard to apply to each
observation in flat, tabular dataset. Growth standards are selected based on the
chronological and gestational age for each observation, and the specific
criteria can be found in the [package
documentation](https://docs.ropensci.org/gigs/reference/gigs_zscoring.html).
These functions can be used to investigate growth indicators including
size-for-gestational age, small vulnerable newborns
[@Ashorn2023SmallImpact; @Lawn2023SmallCounting], stunting, wasting,
weight-for-age (underweight), and micro/macrocephaly.

When benchmarked against each other, ``gigs`` for R outperforms almost all
the packages mentioned above, or is at most a few milliseconds slower. It does
this whilst checking inputs to ensure they are formatted correctly, to make life
Expand All @@ -110,13 +115,12 @@ website](https://docs.ropensci.org/gigs/articles/benchmarking.html).
In addition to the R package, a
[Stata package](https://www.github.com/lshtm-gigs/gigs-stata/) and
[SAS package](https://www.github.com/SASPAC/gigs/) are available for users of
these statistical softwares. All versions of ``gigs`` are already in use by
these statistical software. All versions of ``gigs`` are already in use by
researchers at LSHTM, Harvard, the [Small Vulnerable Newborn
Collaboration](https://www.thelancet.com/series/small-vulnerable-newborns) and
an international collaboration investigating stillbirths, led by Eric Ohuma.
Thanks to its speed, input checking, and unit test-backed accuracy, we believe
``gigs`` will be used widely by those looking to assess newborn, infant, or
child growth in R.
an international collaboration investigating stillbirths. Thanks to its speed,
input checking, and unit test-backed accuracy, we believe ``gigs`` will be used
widely by those looking to assess newborn, infant, or child growth in R.

# Acknowledgements

Expand All @@ -127,4 +131,4 @@ Ordu and Chitra Saraswati - and handling editor Rebecca Killick, whose feedback
and guidance through the rOpenSci software review process has been extremely
useful.

# References
# References

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