Table 5. Diagnostic performance of current and identified optimal MUAC cutoffs and evaluated alternative case definitions for severe wasting.

Categories	Severe Wasting
	Cutoff (cm)	AUROC (LB-UB)	Sensitivity	Specificity	PPV	NPV
All children	Current (<11.5cm)	0.558 (0.539–0.576)	12.62%	98.92%	10.66%	99.10%
	<13.6	0.690 (0.662–0.717)	61.81%	76.09%	2.58%	99.49%
	<13.4 or WAZ <-3	0.752 (0.727–0.777)	72.17%	78.26%	3.28%	99.64%
	<11.6 or WAZ <-2	0.801 (0.779–0.823)	80.58%	79.62%	3.89%	99.75%
Age (months)
6–23 m	<11.5cm	0.598 (0.562–0.633)	22.22%	97.29%	11.19%	98.79%
	<13.0	0.650 (0.607–0.692)	55.56%	74.40%	3.23%	99.09%
24–59	<11.5cm	0.524 (0.507–0.540)	5.17%	99.58%	9.18%	99.23%
	<14.5	0.698 (0.667–0.729)	78.16%	61.47%	1.62%	99.71%
Sex
Male	<11.5cm	0.567 (0.541–0.592)	14.13%	99.17%	16.77%	98.99%
	<13.7	0.704 (0.669–0.738)	65.22%	75.49%	3.04%	99.46%
Female	<11.5cm	0.545 (0.518–0.572)	10.40%	98.64%	6.16%	99.23%
	<13.4	0.683 (0.641–0.726)	63.20%	73.48%	2.00%	99.57%
Weight-for-age z-score (underweight status)
≤ -3SD (Severe)	<11.5cm	0.562 (0.528–0.596)	20.95%	91.43%	28.18%	87.81%
	<12.0	0.588 (0.547–0.628)	35.14%	82.43%	24.30%	88.79%
-2SD < z ≤ -3SD (Moderate)	<11.5cm	0.525 (0.499–0.550)	7.00%	97.93%	6.25%	98.16%
	<13.6	0.564 (0.516–0.613)	60.00%	52.87%	2.45%	98.53%
2SD < z ≤ -2SD (Normal)	<11.5cm	0.505 (0.489–0.521)	1.64%	99.40%	0.70%	99.75%
	<14.2	0.611 (0.548–0.673)	55.74%	66.37%	0.42%	99.83%
Height-for-age z-score (stunting status)
≤ -3SD (Severe)	<11.5cm	0.665 (0.595–0.734)	36.17%	96.82%	16.67%	98.85%
	<12.7	0.797 (0.738–0.857)	78.72%	80.70%	6.69%	99.54%
-2SD < z ≤ -3SD (Moderate)	<11.5cm	0.561 (0.510–0.612)	13.64%	98.57%	5.61%	99.46%
	<13.4	0.707 (0.637–0.777)	68.18%	73.21%	1.56%	99.73%
2SD < z ≤ -2SD (Normal	<11.5cm	0.533 (0.516–0.551)	7.34%	99.31%	10.19%	99.02%
	<14.5	0.683 (0.655–0.711)	77.52%	59.05%	1.98%	99.60%

Note: AUROC = Area Under the Receiver-Operator Characteristic Curve; LB = Lower bound; UB = Upper bound; PPV = Positive predictive value; NPV = Negative predictive value