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Height velocity screening: the real world

A Thakrar1, E M Taylor, J K Wales

  • 1St. George's Hospital, Sheffield.

Journal of Public Health Medicine
|June 1, 1994
PubMed
Summary
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The Middlesex-Height Velocity Screening Chart may lead to unnecessary referrals for children

Area of Science:

  • Pediatric Endocrinology
  • Child Growth Monitoring
  • Public Health Screening

Background:

  • Accurate monitoring of child growth is crucial for identifying potential health issues.
  • Growth charts are essential tools for assessing deviations from normal developmental trajectories.
  • The Middlesex-Height Velocity Screening Chart was developed to identify abnormal growth patterns in children.

Purpose of the Study:

  • To evaluate the effectiveness of the Middlesex-Height Velocity Screening Chart in identifying abnormal growth in children.
  • To determine the feasibility of using height velocity screening for growth disorders in a school setting.

Main Methods:

  • Measured heights of 229 children (aged 4.5-6.8 years) on two occasions at least 12 months apart.
  • Calculated height velocity standard deviation scores using Tanner-Whitehouse standards.

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  • Assessed children against the Middlesex Screening Chart's criteria for normal growth rate.
  • Main Results:

    • 41% (95 out of 229) of children fell outside the 'normal' growth range.
    • Uncritical application of the chart could lead to approximately 2500 referrals for 5-6-year-olds in Sheffield alone.
    • High potential for over-referral due to the screening method's sensitivity and measurement challenges.

    Conclusions:

    • Height velocity screening using the Middlesex chart is not currently feasible due to a high rate of false positives.
    • The study highlights significant concerns regarding the practical application and potential over-referral associated with current height velocity screening methods.
    • Further research is needed to develop more accurate and efficient methods for screening growth disorders in children.