Not all short kids need screening: new study

Short stature is not a reliable indicator for other diseases in children, according to a new study.
Short stature is not a reliable indicator for other diseases in children, according to a new study.

Kids who are short for their age but otherwise healthy probably don’t need extensive blood tests to determine if a disease is stunting their growth, researchers said in a new study.

Of 235 short kids without symptoms who were referred for specialty testing, just three had a possible diagnosis picked up on those labs, and only one diagnosis — for celiac disease — was confirmed, researchers found.

“Most of the screening tests are for diseases you really wouldn’t want to miss, but it’s rare that any of those diseases [would only] present with short stature,” said by Dr. Stephanie Sisley, who led the study.

Guidelines on short stature from endocrinology groups recommend lab screening for very short children, including those who don’t have any problems picked up on a physical exam. That screening includes blood tests for thyroid and growth hormones as well as calcium and other nutrients.

But one of the authors of those guidelines agreed that based on the new findings, kids who are short but have no other symptoms probably don’t need extensive screening.

Sisley and her colleagues reviewed the medical charts of 1,373 short children who were referred to the endocrinology clinic at Cincinnati Children’s Hospital Medical Center between 2008 and 2011. Of them, 235 were below the third percentile for height and had a normal check-up and no record of having stopped growing.

A 10-year-old girl who is 4 feet, 1 inch tall would fall just below the third percentile, for example, as would a 6-year-old boy who is 3 feet, 5 inches.

Few of those children underwent all tests recommended by the guidelines; the average kid had about two-thirds of them. One was diagnosed with celiac disease — when the body can’t process certain grains — and two others had signs of underlying conditions but didn’t finish follow-up tests.

There were 10 false positive lab results that didn’t pan out on further testing.

Altogether, the tests cost $315,321 — or $105,107 per possible diagnosis, the study team reported in The Journal of Pediatrics.

Sisley and her colleagues said their findings show many children are inappropriately referred to specialists for short stature. Rather than looking at a child’s height at one point, it’s more important to track it over time to see if a kid has stopped growing, they wrote.

“Any patient who really isn’t growing should be checked out,” Sisley, now at Baylor College of Medicine in Houston, told Reuters Health.

Dr. Alan Rogol, a professor emeritus at the University of Virginia in Charlottesville, agreed the new findings only apply to those kids who are short but have no record of growth delay.

The kids in this study “had nothing that pointed to difficulty in any system, and many of them were short kids of shorter parents,” Rogol, who reviewed the study for the journal, told Reuters Health.

He and Sisley both said those kids should be followed by their pediatrician for at least six months, then referred to a specialist if they really aren’t growing, or any time new symptoms show up.

“In this idealized set of kids, the things that pediatricians do best … are probably more worthwhile than sending them over to see an endocrinologist or somebody else,” Rogol said.

“I think parents are most worried that they’re missing something in the kid. It’s actually OK to follow the growth of a patient for six months or 12 months to see if something’s going on before you do specialized testing,” Sisley said.

“Much of the time, if their child is otherwise healthy … the bottom line is they’re probably going to be fine in the long run.”



News
Entertainment
Sports
Lifestyle
National

Sprint and T-Mobile offer further price discounts

Sprint unveiled a plan on Thursday that gives subscribers access to unlimited data for $60 a month, the industry's cheapest unlimited data offering.

National

Hundreds pay it forward at Florida Starbucks in…

The spontaneous chain of kindness continued for about 11 hours, totaling 457 transactions by the time it ended.

National

Weather system east of Caribbean could turn into…

An area of low pressure located east of the Caribbean Sea has a 50 percent chance of becoming a tropical depression or storm in the next 48 hours, U.S. forecasters…

National

U.S. hospital to discharge doctor treated with experimental…

An American doctor who contracted Ebola treating victims of the deadly virus in Liberia has recovered and will be discharged on Thursday by the Atlanta hospital that treated him with…

Movies

Review: 'When the Game Stands Tall' is both…

The high school football saga "When the Game Stands Tall" fumbles around for a focus while Jim Caviezel offers the most low-key coach in history.

Movies

Girlfriend in a coma: Chloe Grace Moretz

Chloe Grace Moretz is the best cheerleader "If I Stay" could ask for. As the star of the film adaptation of the successful YA novel…

The Word

The Word: Summer lovin' for Zac Efron and…

Ah, the summer romance. So intense, so fleeting. With Labor Day fast approaching, it should come as little surprise that the incredibly surprising romance between…

The Word

The Word: The Zac Efron-Michelle Rodriguez summer fling…

  Ah, the summer romance. So intense, so fleeting. With Labor Day fast approaching, it should come as little surprise that the incredibly surprising romance…

NFL

Fantasy football draft guide: How to draft your…

Many are wondering if we’re entering a new age in fantasy football drafting — one where running backs take a backseat.

NFL

Jets vs. Giants: 3 Giants storylines to watch

The Giants have plenty to work on as they reach the dress rehearsal preseason game Friday night against the rival Jets.

NFL

Jets vs. Giants: 3 Jets storylines to watch

Metro looks at three Jets storylines to watch as they play the Giants Friday.

NFL

Giants expected to work Corey Washington into first-team…

The day of reckoning for the Giants' fringe players will fall upon them Friday night against the Jets.

Sex

Big weddings may lead to long-term happiness

Dreaming of a big wedding? A new study indicates that the longer your guest list, the happier you’ll be in the long run. l A…

Sex

Online dating for every generation

Frank Jackson and his mother Maggie are like lots of modern families: They have dinner together regularly, keep each other updated on their lives —…

Wellbeing

Going green could be the key to getting…

If we could just pursue the things that would actually make us happy, we could help the environment too, according to a New York researcher.…

Tech

Siren: A new dating app that puts women…

Online dating can be brutal, especially for single women. Noting that many women hate wading through inappropriate messages and photos, two tech entrepreneurs decided to…