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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
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Developing evidence-based guidelines for referral for short stature.

F K Grote1, P van Dommelen, W Oostdijk

  • 1Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.

Archives of Disease in Childhood
|October 3, 2007
PubMed
Summary

New guidelines for monitoring child growth effectively identify growth disorders in children aged 3-10 years with high accuracy. These evidence-based criteria offer a low false-positive rate for better population health surveillance.

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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Area of Science:

  • Pediatric endocrinology
  • Auxology
  • Population health

Background:

  • Accurate growth monitoring is crucial for early detection of pediatric health issues.
  • Existing methods for population-based growth surveillance require refinement for optimal sensitivity and specificity.

Purpose of the Study:

  • To develop and validate evidence-based guidelines for population-based growth monitoring.
  • To establish sensitive and specific criteria for identifying growth deviations in children.

Main Methods:

  • Formulation of auxological referral criteria based on height standard deviation score (HSDS) and distance to target height.
  • Application of criteria to longitudinal growth data from patient cohorts and general population samples.
  • Evaluation of sensitivity and false-positive rates for different age groups (0-3 years and 3-10 years).

Main Results:

  • For children aged 3-10 years, a combination of distance to target height (>2 SD) and HSDS (<-2.0) demonstrated the highest predictive value.
  • Incorporating severe short stature (<-2.5 SDS) and height deflection rules improved detection rates for specific conditions like Turner syndrome (85.7%) and other growth disorders (76.5%) with a 1.5-2% false-positive rate.
  • For infants aged 0-3 years, detecting pathology required HSDS below -3 or two observations below -2.5 SDS, with a <1% false-positive rate, though sensitivity was lower than in older children.

Conclusions:

  • The proposed growth monitoring guidelines show high sensitivity and acceptable false-positive rates for children aged 3-10 years, with distance to target height being a key indicator.
  • Sensitivity is considerably lower in children under 3 years.
  • The developed algorithm is suitable for industrialized nations and warrants further validation in diverse populations.