The "PAWPER-on-a-page": Increasing global access to a low-cost weight estimation system.

Abstract

The PAWPER tape is one of the most accurate weight estimation systems available today, but international access to the tape is limited because it has no commercial distribution. For this reason, the "PAWPER-on-a-page" concept was devised: downloadable image files that allow users to print and assemble their own tapes. However, the feasibility of this method is dependent on users being able to produce accurate tapes. This study was devised to determine whether untrained participants could print and assemble the "PAWPER-on-a-page" easily and accurately. Doctor and nurse volunteers downloaded the "PAWPER-on-a-page" and "PAWPER XL-on-a-page" image files and printed copies on a home-printer and also at a commercial printer. One copy of each tape was then assembled according to instructions from an online video. The accuracy of printing and assembly, the time taken for assembly and the cost were then evaluated. There were 32 participants. The median time for assembly was 8 minutes 19 seconds and 7 minutes 31 seconds for the "PAWPER-on-a-page" and "PAWPER XL-on-a-page" respectively, with a median cost of USD 0.09 and USD 1.00 respectively. For the assembled tapes, 71.9% of the "PAWPER-on-a-page" tapes and 65.6% of the "PAWPER XL-on-a-page" achieved the required accuracy of 0.2%. Printing errors, related to scaling, were common, but easily detectable. The "PAWPER-on-a-page" system can be easily, quickly, affordably and accurately printed and assembled by end users. Stringent double checking of the printed and fully assembled tapes is essential to ensure accuracy.