Title
Developing evidence-based guidelines for referral for short stature
Author
Grote, F.K.
van Dommelen, P.
Oostdijk, W.
de Muinck Keizer-Schrama, S.M.P.F.
Verkerk, P.H.
Wit, J.M.
van Buuren, S.
TNO Kwaliteit van Leven
Publication year
2008
Abstract
Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population. Results: Almost 30% of pathology can be detected by height standard deviation score (HSDS) below -3 or at least two observations of HSDS below -2.5 at a low false-positive rate (<1%) in 0-3-year-old infants. For 3-10-year olds, a rule concerning distance to target height of >2 SD in combination with HSDS <-2.0 has the best predictive value. In combination with a rule on severe short stature (<-2.5 SDS) and a minor contribution from a rule on "height deflection", 85.7% of children with Turner syndrome and 76.5% of children who are short because of various disorders are detected at a false-positive rate of 1.5-2%.Conclusions: The proposed guidelines for growth monitoring show high sensitivity at an acceptably low false-positive rate in 3-10-year-old children. Distance to target height is the most important criterion. Below the age of 3 years, the sensitivity is considerably lower. The resulting algorithm appears to be suitable for industrialised countries, but requires further testing in other populations.
Subject
Health
Algorithm
Celiac disease
Cystic fibrosis
Diagnostic accuracy
Diagnostic value
Evidence based practice
False positive result
Industrialization
Major clinical study
Monitoring
Observational study
Pathology
Patient referral
Population
Practice guideline
Priority journal
Sample
Scoring system
Short stature
Turner syndrome
Clinical trial
Methodology
Multicenter study
preschool child
Body Height
Child
Child Development
Child, Preschool
Female
Growth Disorders
Humans
Infant
Infant, Newborn
Male
Mass Screening
Netherlands
Practice Guidelines as Topic
Sensitivity and Specificity
Sex Factors
To reference this document use:
http://resolver.tudelft.nl/uuid:43e34661-8bdc-42b4-b032-d51b0563b713
DOI
https://doi.org/10.1136/adc.2007.120188
TNO identifier
240686
ISSN
0003-9888
Source
Archives of Disease in Childhood, 93 (3), 212-217
Document type
article