Evaluation of a district growth screening programme: the Oxford Growth Study.

Ahmed, Marion L.; Allen, Alison; Sharma, Abhishek; MacFarlane, James; Dunger, David B.

doi:10.1136/adc.69.3.361

Cited by 61 publications

(32 citation statements)

References 13 publications

(1 reference statement)

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“…First, the prevalence of pathological causes among all the children of this cohort is comparable to most previous observations in children with growth failure, reporting an incidence between 1.3 and 19.8% [3], [18,19,20,21,22,23]. In none of these studies was a complete detailed routine diagnostic workup performed.…”

Section: Discussionsupporting

confidence: 51%

Application of the Dutch, Finnish and British Screening Guidelines in a Cohort of Children with Growth Failure

Stalman

Hellinga

Dommelen³

et al. 2015

Horm Res Paediatr

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Aims: To evaluate three guidelines for selecting short children for diagnostic workup in a general pediatric clinic. Methods: All patients (n = 131) aged 3.00-9.99 years who were referred for growth failure to a general pediatric clinic were evaluated for their medical history and growth and examined. All of them underwent the same standardized diagnostic workup. Retrospectively, the criteria for the diagnostic workup from three guidelines (proposed in the Netherlands, Finland and the UK) were applied, and their sensitivity was assessed. A Dutch reference sample (n = 958) was used for calculating population specificity. Results: In 23 patients (17.6%), a pathological cause of their growth failure was found. The sensitivity of the original Dutch, Finnish and British guidelines was 73.9, 78.3 and 56.5% and their specificity 98.5, 83.7 and 95.8%, respectively. When adding recent growth deflection to the Dutch guideline, sensitivity increased to 87%, but specificity decreased markedly (to 87%). Conclusion: The proposed cutoff values for height standard deviation score and distance to target height/mid-parental height, as used in the Netherlands and Finland, are effective for population growth monitoring, and superior to the monitoring algorithm in the UK. Growth deflection irrespective of height is an important sign of acquired growth disorders, but its specificity is too low for population screening.

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Section: Discussionsupporting

confidence: 51%

Application of the Dutch, Finnish and British Screening Guidelines in a Cohort of Children with Growth Failure

Stalman

Hellinga

Dommelen³

et al. 2015

Horm Res Paediatr

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“…In the Wessex growth study, eight children (4.4%) were identified as having an organic disease among the 180 children, whose height on screening at school entry was below the 3rd percentile [104]. In the Oxford study, Ahmed et al reported seven newly recognized children (3.0%) with organic disease among the 260 children whose height was below À2 SDS, measured at the ages of 3 and 4.5 years [103]. In the Utah growth study [105], twenty-five out of 555 children (4.5%) were newly discovered as having GHD, hypothyroidism or Turner syndrome and another 53 children (9.5%) had other medical reasons for their poor growth (height below the 3rd percentile and/or growth rate below 5 cm/year).…”

Section: What Is the Frequency Of Iss Amongst Short Children?mentioning

confidence: 97%

“…The percentage of pathology found in most studies is approximately 5% [103][104][105]. In the Wessex growth study, eight children (4.4%) were identified as having an organic disease among the 180 children, whose height on screening at school entry was below the 3rd percentile [104].…”

Section: What Is the Frequency Of Iss Amongst Short Children?mentioning

confidence: 99%

Idiopathic short stature: Definition, epidemiology, and diagnostic evaluation

Wit

Clayton

Rogol

et al. 2008

Growth Hormone & IGF Research

208

179

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“…However, some patients classified as having ISS may exhibit conditions that are not detected by the conventional workup. ISS accounts for 0.9-60% of all cases of short stature, depending on the country (percentage of malnutrition) or the population of the study (whole population or subgroup of small children) (3,4,5,6,7,8,9,10,11). To date, only three studies have routinely investigated patients with ISS for skeletal dysplasia (SD), which was found in 2.3 (9), 5.6 (3), and 11.4% (11) of cases respectively.…”

Section: Introductionmentioning

confidence: 99%

Unexpected high frequency of skeletal dysplasia in idiopathic short stature and small for gestational age patients

Flechtner

Lambot-Juhan

Teissier

et al. 2014

European Journal of Endocrinology

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Objective: To assess the prevalence of skeletal dysplasias (SDs) in patients with idiopathic short stature (ISS) or small for gestational age (SGA) status. Setting: Rare Endocrine/Growth Diseases Center in Paris, France. Design: A prospective study on consecutive patients with ISS and SGA enrolled from 2004 to 2009. Method: We used a standardized workup to classify patients into well-established diagnostic categories. Of 713 patients with ISS (nZ417) or SGA status (nZ296), 50.9% underwent a skeletal survey. We chose patients labeled normal or with a prepubertal slowdown of growth as a comparison group. Results: Diagnoses were ISS (16.9%), SGA (13.5%), normal growth (24.5%), transient growth rate slowing (17.3%), endocrine dysfunction (12%), genetic syndrome (8.9%), chronic disease (5.1%), and known SD (1.8%). SD was found in 20.9% of SGA and 21.8% ISS patients and in only 13.2% in our comparison group. SD prevalence was significantly higher in the ISS group than in the comparison group, especially (50%) for patients having at least one parent whose height was !K2 SDS. Dyschondrosteosis and hypochondroplasia were the most frequently identified SD, and genetic anomaly was found in 61.5 and 30% respectively. Subtle SD was found equally in the three groups and require long-term growth follow-up to evaluate the impact on final height. Conclusion: SD may explain more than 20% of cases of growth retardation ascribed to ISS or SGA, and this proportion is higher when parental height is !K2 SDS. A skeletal survey should be obtained in patients with delayed growth in a context of ISS or SGA.

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Evaluation of a district growth screening programme: the Oxford Growth Study.

Cited by 61 publications

References 13 publications

Application of the Dutch, Finnish and British Screening Guidelines in a Cohort of Children with Growth Failure

Application of the Dutch, Finnish and British Screening Guidelines in a Cohort of Children with Growth Failure

Idiopathic short stature: Definition, epidemiology, and diagnostic evaluation

Unexpected high frequency of skeletal dysplasia in idiopathic short stature and small for gestational age patients

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