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Predictive Value of IAP 2015, IAP 2007 and WHO Growth Charts in Identifying Pathological Short Stature
Riddhi Patel1, Chetankumar Dave1, Neha Agarwal1
1Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur and GROW Society, Growth and Obesity Workforce, Kanpur, India.
Insights
The Indian Academy of Pediatrics (IAP) 2015 growth charts are superior for identifying pathological short stature in Indian children compared to WHO and IAP 2007 charts. These findings aid in accurate diagnosis of growth failure.
Area of Science:
- Pediatric Endocrinology
- Growth Monitoring
- Diagnostic Accuracy
Background:
- Accurate identification of pathological short stature is crucial for timely intervention in children.
- Existing growth charts, including WHO and Indian Academy of Pediatrics (IAP) 2007, have varying diagnostic capabilities.
- The IAP 2015 growth charts were developed to potentially improve the assessment of child growth in India.
Purpose of the Study:
- To compare the diagnostic accuracy of the Indian Academy of Pediatrics (IAP) 2015, World Health Organization (WHO), and IAP 2007 growth charts.
- To evaluate the effectiveness of these growth charts in identifying pathological short stature among Indian children.
Main Methods:
- A study involving 500 short children (aged 5-17.9 years) presenting to a pediatric endocrine clinic.
- Assessment of the predictive value of WHO, IAP 2015, and IAP 2007 growth charts for pathological short stature.
- Calculation of diagnostic measures including sensitivity, specificity, and predictive values for each chart.
Main Results:
- The IAP 2015 criteria identified 82% of subjects as short, while IAP 2007 identified 66.2%, and WHO identified all subjects (100%).
- A pathological cause for short stature was found in 43.6% of the subjects.
- The IAP 2015 charts demonstrated higher sensitivity (99.1%) and negative predictive value (97.8%) compared to IAP 2007 (sensitivity 81.7%, NPV 76.3%) in identifying pathological short stature.
Conclusions:
- The IAP 2015 growth charts are superior to WHO and IAP 2007 charts in identifying pathological growth failure in Indian children.
- Utilizing IAP 2015 charts can lead to more accurate and timely diagnosis of growth disorders.
Objective:
To compare the diagnostic accuracy of IAP 2015, WHO and IAP 2007 growth charts in identifying pathological short stature in Indian children.
Methodology:
The predictive value of the growth charts for pathological short stature was assessed in 500 (266 boys) short subjects (age 5-17.9 years) presenting to our pediatric endocrine clinic.
Results:
WHO, IAP 2015, IAP 2007 criteria classified 500, 410 (82%) and 331 (66.2%) subjects short respectively. A total of 218 (43.6%) subjects had a pathological cause. Two out of 90 subjects short by WHO criteria but normal as per IAP 2015 had a pathological cause (2.2%) whereas 38 out of 79 subjects short as per WHO and IAP 2015 criteria but normal by IAP 2007 had pathological short stature. The diagnostic measures of IAP 2015 and IAP 2007 charts in identifying pathological short stature showed a sensitivity 99.1% and 81.7%, negative predictive value 97.8% as against 76.3%, positive predictive value 52.7% and 53.8%, and specificity of 31.2% and 45.7%, respectively.
Conclusion:
IAP 2015 growth charts are superior in identifying pathological growth failure compared to WHO and IAP 2007.
