Variability in the management of healthy short youth following GH stimulation testing.

Background/Objectives: Recent Delphi survey of endocrinologists revealed low consensus regarding the diagnosis of pediatric growth hormone deficiency (GHD). Thus, we sought to describe the various trajectories undertaken by healthy 8-14 year old youth in the 2 years following testing for GHD at a single major pediatric academic institution. Methods: Electronic health records were reviewed for the current analysis from healthy 8-14 year old participants enrolled in a prospective longitudinal observational study of parent and youth characteristics associated with youth quality of life and self-esteem over a two-year period following growth hormone (GH) stimulation testing. Participants were grouped according to their peak GH concentration on testing (<7, 7-10, and ≥10 ng/ml), and outcomes included treatment (or not) with GH or other growth-altering hormonal treatments. Results: Of the 115 participants, 27 (23%) had peak GH <7 ng/ml, 27 (23%) 7-10 ng/ml, and 61 (53%) peaked ≥10 ng/ml. Across the 3 groups, some patients were not offered GH treatment, some were offered yet did not pursue treatment, and some were offered and treated - with further variance provided by GH treatment interruptions, early cessation Conclusions: Even within the network of a single academic institution, variability is evident in the management of healthy 8-14 year old short youth following GH stimulation testing.