Evidence map›Paper›PMID 36053660›Full record

Observational studyBMJ paediatrics open2022

Evaluating the sensitivity and specificity of the UK and Dutch growth referral criteria in predicting the diagnosis of pathological short stature.

Gemma White, Shakira Cosier, Afiya Andrews, Lee Martin, Ruben Willemsen, Martin O Savage, Helen L Storr

Open access · diamondAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ paediatrics open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 86% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Well, How Did We Get Here? The Current State of Pediatric Endocrinology.Journal of pediatrics. Clinical practice · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Gemma White *Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University, London EC1M 6BQ, UK.ORCID 0000-0001-7340-5517
Shakira Cosier *Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University, London EC1M 6BQ, UK.
Afiya AndrewsCentre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University, London EC1M 6BQ, UK.ORCID 0000-0003-2390-657X
Lee MartinDepartment of Paediatric Endocrinology, The Children's Hospital at the Royal London Hospital, Whitechapel, London E1 1FR, UK.
Ruben WillemsenDepartment of Paediatric Endocrinology, The Children's Hospital at the Royal London Hospital, Whitechapel, London E1 1FR, UK.ORCID 0000-0002-4891-2506
Martin O SavageCentre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University, London EC1M 6BQ, UK.ORCID 0000-0001-7902-3376
Helen L StorrCentre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University, London EC1M 6BQ, UK h.l.storr@qmul.ac.uk.ORCID 0000-0002-9963-1931
William Harvey Research Institute · GBRoyal London Hospital · GBQueen Mary University of London · GB

Funding

Department of Health
6 · The paper itself

Abstract

objectiveThe aim of this observational study was to evaluate the UK and Dutch referral criteria for short stature to determine their sensitivity and specificity in predicting pathological short stature. Adherence to the recommended panel of investigations was also assessed. STUDY

designRetrospective review of medical records to examine the auxological parameters, investigations and diagnosis of subjects referred to two paediatric endocrine clinics at the Royal London Children's Hospital between 2016 and 2021. We analysed: height SD score (HtSDS), height SDS minus target height SDS (Ht-THSDS) and height deflection SDS (HtDefSDS). The UK referral criteria were HtSDS <-2.7, Ht-THSDS >2.0 and HtDefSDS >1.3. The Dutch referral criteria were HtSDS <-2.0, Ht-THSDS >1.6 and HtDefSDS >1.0.

resultsData were available for 143 subjects (72% males) with mean (range) age 8.7 years (0.5-19.9). HtSDS and Ht-THSDS were significantly lower in the pathological stature (n=66) versus the non-pathological stature (n=77) subjects (-2.67±0.82 vs -1.97±0.70; p<0.001 and -2.07±1.02 vs -1.06±0.99; p<0.001, respectively). The sensitivity and specificity to detect pathology was 41% and 83% for the UK criteria (HtSDS <-2.7) compared with 59% and 79% for the Dutch criteria (HtSDS <-2.0), 48% and 83% for UK criteria (Ht-THSDS <-2.0) compared with 74% and 72% for Dutch criteria (Ht-THSDS <-1.6) and 33% and 68% for UK criteria (HtDefSDS >1.3) compared with 44% and 63% for the Dutch criteria (HtDefSDS >1.0). On average, each patient had 88% of the recommended investigations, and 53% had all the recommended testing. New pathology was identified in 36% of subjects.

conclusionsIn isolation, the UK auxological referral thresholds have limited sensitivity and specificity for pathological short stature. The combination of HtSDS and Ht-THSDS improved the sensitivity of UK criteria to detect pathology from 41% to 68%. Attention to the child's genetic height potential prior to referral can prevent unnecessary assessments.

Indexed as

Body HeightDwarfismChildFemaleGrowth DisordersHumansMaleReferral and ConsultationUnited KingdomEndocrinologyGrowth

Identifiers

PMID36053660
PMCPMC9295664
OpenAlexW4285498027

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.