ArticlePediatrics2011
Medically underserved girls receive less evaluation for short stature.
Article in Pediatrics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective.Hormone research in paediatrics · 2019Guideline
- Global burden and between-country inequalities in Turner syndrome from 1990 to 2021.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Evaluation of thyrotrophic and lactotrophic reserves in patients with pituitary dwarfism with and without empty sella turcica.Journal of pediatric endocrinology & metabolism : JPEM · 2025Article
- Sex and racial/ethnic disparities in children presenting for short stature evaluation: in-depth analysis at a single center.Annals of pediatric endocrinology & metabolism · 2025Article
- Sex Difference in Paediatric Growth Hormone Deficiency: Fact or Fiction?Clinical endocrinology · 2025Article
- Clinical and genetic spectrum of Fanconi anemia in Australia and New Zealand.Genetics in medicine open · 2025Article
- Insurance Status and Tumor Necrosis Factor Inhibitor Initiation Among Children With Juvenile Idiopathic Arthritis in the CARRA Registry.The Journal of rheumatology · 2023Article
- Views on Short Stature of Female vs Male Endocrine Pediatric Patients Undergoing Provocative Growth Hormone Testing and Their Parents.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2023Article
- Endocrine Health and Health Care Disparities in the Pediatric and Sexual and Gender Minority Populations: An Endocrine Society Scientific Statement.The Journal of clinical endocrinology and metabolism · 2023Article
- Identifying and addressing disparities in the evaluation and treatment of children with growth hormone deficiency.Frontiers in endocrinology · 2022Review
- Regional differences in short stature in England between 2006 and 2019: A cross-sectional analysis from the National Child Measurement Programme.PLoS medicine · 2021Article
- Focused Revision: ACMG practice resource: Genetic evaluation of short stature.Genetics in medicine : official journal of the American College of Medical Genetics · 2021Article
- Clinical and genetic characteristics of hypophosphatasia in Chinese children.Orphanet journal of rare diseases · 2021Article
- Growth Hormone Stimulation Testing Patterns Contribute to Sex Differences in Pediatric Growth Hormone Treatment.Hormone research in paediatrics · 2021Article
- Dilemmas of growth hormone treatment for GH deficiency and idiopathic short stature: defining, distinguishing, and deciding.Minerva pediatrica · 2020Review
- Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review.JMIR public health and surveillance · 2019Review
- Racial/Ethnic Disparities in US Pediatric Growth Hormone Treatment.Hormone research in paediatrics · 2018Article
- Electronic Health Record Mid-Parental Height Auto-Calculator for Growth Assessment in Primary Care.Clinical pediatrics · 2016Article
- Growth Charts for Children With Down Syndrome in the United States.Pediatrics · 2015Article
- Gender Bias in U.S. Pediatric Growth Hormone Treatment.Scientific reports · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo determine if gender is associated with diagnostic evaluation by primary care pediatricians caring for children with growth-faltering. PATIENTS AND
methodsThis was a retrospective study of children who were attending 4 urban pediatric primary care practices affiliated with a tertiary pediatric hospital. Growth-faltering was defined as height at the <5th percentile or a z-score decrease of ≥ 1.5 SDs before 18 months of age or ≥ 1 SD thereafter. For each child, height z score, age, gender, race, insurance, diagnostic tests, and subspecialist appointments were examined.
resultsOf 33 476 children, 3007 had growth-faltering (mean height: -1.5 ± 1.0 vs 0.3 ± 0.9 SDs in those without growth-faltering). Boys comprised 53% of the growth-faltering group (vs 51% of the nonfaltering group; P < .01). Among children with growth-faltering, 2.8% had endocrinology appointments (vs 0.8% of others; P < .0001) and 6% had gastroenterology appointments (vs 1.5% of others; P < .0001). Subspecialty care was not associated with gender. Pediatricians ordered diagnostic tests for a significantly greater proportion of children with growth-faltering than others. In multivariate analysis of height z score among children with growth-faltering, tests for chromosomes (1.4% of short girls vs 0.4% of short boys; P < .005) and growth hormone/insulin-like growth factor axis (0.9% of short girls vs 1.8% of short boys; P < .05) were associated with gender. Thirty-five percent of the girls for whom chromosome testing was performed were 12 years old or older.
conclusionsPatterns in diagnostic testing of children with growth-faltering by their pediatricians may lead to underdiagnosis of Turner syndrome and growth hormone deficiency among girls.
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