Evidence map›Paper›PMID 40335774›Full record

ReviewPituitary2025

Consensus and controversies about diagnosing GH deficiency: a Delphi survey by the GH research society.

M C Arlien-Søborg, S Radovick, M C S Boguszewski, M Bidlingmaier, G Johannsson, A Grimberg, K K Y Ho, B M K Biller, C S Choong, A R Hoffman and 34 more

Erratum issuedAbstract readReviewConsensus Statement
PubMed Publisher
In one paragraph

Review in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
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

12 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Review
  7. An update on hypophysitis.Nature reviews. Endocrinology · 2026
    Review
  8. Review
  9. Article
  10. Evaluation of temporal muscle thickness in subjects with acromegaly: a follow-up study.Therapeutic advances in endocrinology and metabolism · 2026
    Article
  11. Article
  12. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

44 authors.

M C Arlien-SøborgDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
S RadovickDepartment of Pediatrics, Rutgers University-Robert Wood Johnson Medical School New, Brunswick, NJ, USA.
M C S BoguszewskiDepartment of Pediatrics, Federal University of Parana, Curitiba, Brazil.
M BidlingmaierDepartment of Medicine IV, LMU University Hospital, LMU Munich, München, Germany.
G JohannssonDepartment of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden.
A GrimbergDivision of Endocrinology and Diabetes, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA.
K K Y HoGarvan Institute of Medical Research and St. Vincent's Hospital, Sydney, NSW, Australia.
B M K BillerNeuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
C S ChoongDepartment of Endocrinology, Perth Children's Hospital & School of Medicine, University of Western Australia, Crawley, WA, Australia.
A R HoffmanDepartment of Medicine, Stanford University, Stanford, CA, USA.
P BackeljauwDivision of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
C L BoguszewskiEndocrine Division (SEMPR), Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil.
J BollerslevFaculty of Medicine, University of Oslo, Oslo, Norway.
T BrueDepartment of Endocrinology, Conception University Hospital, Marseille, France.
P ChansonService d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
E ChristDepartment of Endocrinology, Diabetology and Metabolism and Endocrine and Neuroendocrine Tumor Center, University Hospital of Basel, Basel, Switzerland.
S CianfaraniDepartment of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
P E ClaytonDevelopmental Biology & Medicine, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
P CohenLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
A DauberDivision of Endocrinology, Children's National Hospital, Washington, DC, USA.
M FleseriuDepartments of Medicine and Neurological Surgery, Pituitary Center, Oregon Health Sciences University, Portland, OR, USA.
J GebauerDepartment of Internal Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany.
A GiustinaVita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy.
C E HighamDepartment of Endocrinology, Christie Hospital NHS Foundation Trust and Division of Cancer Sciences,, University of Manchester, Manchester, UK.
R HorikawaDivision of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.
C HöybyeDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
A JuulDepartment of Growth and Reproduction-Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
M LodishUniversity of California, San Francisco, CA, USA.
X LuoDepartment of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
N MaurasNemours Children's Health Jacksonville, Jacksonville, FL, USA.
K K MillerNeuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
S MelmedPituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
S J C M M NeggersErasmus University Medical Centre, Rotterdam, The Netherlands.
N KaravitakiDepartment of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, UK.
R RosenfeldDepartment of Pediatrics, Oregon Health Science University, Portland, OR, USA.
R RossUniversity of Sheffield, Sheffield, UK.
L SavendahlDivision of Pediatric Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
K SchilbachDepartment of Medicine IV, LMU University Hospital, LMU Munich, München, Germany.
P F Collett-SolbergDiscipline of Endocrinology, Internal Medicine Department, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
C J StrasburgerCharité Universitätsmedizin, Berlin, Germany.
N A TritosNeuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
H M van SantenDepartment of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center and Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
K C J YuenDepartment of Neuroendocrinology, St. Joseph's Hospital and Medical Center, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA.
J O L JorgensenDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. joj@clin.au.dk.ORCID http://orcid.org/0000-0001-7408-1526

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBiochemical tests are required for diagnosing GH-deficiency in children and adults, but controversies remain regarding diagnostic criteria and type of biochemical tests. The aim of the study is to map the clinical practices of GHD diagnosis in children and adults.

methodsThe Growth Hormone Research Society members initiated a Delphi survey of the diagnosis of GHD in children and adults. Pediatric (n = 18) and adult (n = 25) endocrinologists from 14 countries participated and rated their extent of agreement with 61 statements using a Likert-type-scale (1-7). Consensus was predefined as ≥ 80% of panelists rating their agreement unidirectionally as either ≥ 5 (agreement) or ≤ 3 (disagreement).

resultsThe pediatric panel reached consensus on 17 of 29 (59%) statements on diagnosis in children, whereas the adult panel reached consensus on 28 of 32 (88%) statements on adult patients. There was general agreement to test for GHD in an appropriate clinical context and also on the timing of testing for GHD in both children and adults. A subnormal IGF-I level was considered diagnostic in both children and adults with panhypopituitarism. In children, there was consensus to recommend the arginine stimulation test and the glucagon test. The insulin tolerance test (ITT) was considered gold standard in adults and there was also consensus to recommend the macimorelin test. A stimulated GH cut-off < 5μg/l was consistent with severe GHD in children, whereas test-specific cut-offs were recommended in adults.

conclusionConsensus on the GHD diagnosis was lower in pediatric practice, mainly with respect to choice and interpretation of GH stimulation tests.

Indexed as

Human Growth HormoneAdultChildDelphi TechniqueFemaleHumansInsulin-Like Growth Factor IMaleHuman Growth HormoneInsulin-Like Growth Factor IAdult endocrinologyConsensus guidelineDiagnosisGH stimulation testsGrowth hormone deficiencyPediatric endocrinology

Identifiers

PMID40335774

What OpenQuestion holds

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Registered trials

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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.