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Statistical agreement and cost-benefit: Comparison of methods for constructing growth reference charts
Michael Hermanussen1, C Assmann, J Tutkuviene
1Aschauhof, Altenhof, Germany. Hermanussen.aschauhof@t-online.de
Annals of Human Biology
|November 19, 2009
Summary
Synthetic growth references offer a practical and cost-effective alternative to traditional empirical methods for creating pediatric growth charts. These synthetic references closely match national data, unlike international WHO standards which showed significant discrepancies.
Area of Science:
- Pediatric endocrinology
- Biostatistics
- Public health
Background:
- Growth reference charts are crucial for accurate pediatric decision-making.
- Traditional empirical methods for creating growth charts are labor-intensive and costly.
Purpose of the Study:
- To evaluate practicable and less demanding alternatives to empirical growth chart construction.
- To compare Lithuanian national growth charts with international WHO standards and synthetic references.
Main Methods:
- Analysis of agreement using the Bland-Altman method.
- Comparison of 2000-2002 Lithuanian growth charts with WHO international standards and synthetic Lithuanian references.
Main Results:
- Synthetic references showed clinically irrelevant differences compared to Lithuanian charts.
- WHO international standards significantly underestimated height in Lithuanian children, with discrepancies exceeding -6 cm in some cohorts.
Conclusions:
- Synthetic growth references present a clinically relevant, practicable, and cost-effective alternative to empirical methods.
- Economic considerations strongly favor replacing traditional methods with synthetic growth references for national growth chart construction.
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