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Referral criteria for growth screening

J A Hulse1

  • 1Department of Pediatrics, Maidstone Hospital, Kent, United Kingdom.

Journal of Medical Screening
|January 1, 1995
PubMed
Summary

Population height screening identifies organic diseases in children below the third centile. Early detection of growth disturbances, including Turner

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Area of Science:

  • Pediatrics
  • Endocrinology
  • Public Health

Background:

  • Population height screening over 20 years reveals 17-21% of children below the third centile have organic disease.
  • Disease likelihood increases to 50% for children below -3 Standard Deviations (SDs).
  • Screening age impacts detection of acquired diseases and progressive growth disorders like Turner's syndrome.

Purpose of the Study:

  • To evaluate the effectiveness of population height screening in identifying organic diseases in children.
  • To assess the utility of height velocity and height/weight relations in improving screening sensitivity.
  • To determine optimal screening protocols, including measurement frequency and referral systems.

Main Methods:

  • Analysis of population height screening data spanning two decades.
  • Evaluation of height velocity as a screening tool for growth disturbances.
  • Assessment of height/weight relations for early detection of conditions like coeliac disease and eating disorders.
  • Consideration of measurement frequency (minimum three, preferably five-six) for growth pattern definition.
  • Proposal of a two-level referral system for efficient resource allocation.

Main Results:

  • Significant proportion of children with short stature have underlying organic disease.
  • Height velocity and height/weight relations show potential for enhanced screening sensitivity.
  • Early detection of coeliac disease and eating disorders is possible with integrated screening.
  • A minimum of three to six measurements are recommended for accurate growth pattern assessment.
  • Referral for discrepancies greater than three centile bands between height and weight is advised.

Conclusions:

  • Population height screening is crucial for detecting organic diseases and growth disturbances in children.
  • Incorporating height velocity and height/weight assessments can improve early diagnosis.
  • A structured, multi-level referral system optimizes resource use for managing growth issues.

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