Selecting short-statured children needing growth hormone testing: Derivation and validation of a clinical decision rule

Selecting short-statured children needing growth hormone testing: Derivation and validation of a clinical decision rule

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Abstract Background Numerous short-statured children are evaluated for growth hormone (GH) deficiency (GHD).In most patients, GH provocative tests are normal and are thus in retrospect unnecessary.Methods A retrospective cohort study was conducted to identify predictors of growth hormone (GH) deficiency (GHD) in children seen for short cartoon martian with big head stature, and to construct a very sensitive and fairly specific predictive tool to avoid unnecessary GH provocative tests.

GHD was defined by the presence of 2 GH concentration peaks Results The initial study included 167 patients, 36 (22%) of whom had GHD, including 5 (3%) with certain GHD.Independent predictors of GHD were: growth rate Conclusion We have derived and performed an internal validation of a highly sensitive decision rule that could safely help to avoid more than 2/3 of the unnecessary GH tests.External validation of this rule is needed cga 200 to cga 510 adapter before any application.