Editorials

Changing practice in growth monitoring

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7180.344 (Published 06 February 1999) Cite this as: BMJ 1999;318:344

No evidence exists that monitoring height velocity is useful

  1. Linda D Voss, Senior research fellow.
  1. Wessex Growth Study, University Child Health, Southampton General Hospital, Southampton SO 16 6YD

    The French pay child benefits only on production of a school medical certificate confirming that height measurements are up to date. If the French, why not the British? Height is easily measured, and height velocity is claimed to be a sensitive index of many disorders, genetic, metabolic, and psychosocial. More than just a marker for health, growth could be a useful tool for picking up silent disease. All that we lack is the evidence.

    The dilemma of pursuing a screening programme based on a scientifically plausible but unproved hypothesis has recently been raised.1 In particular, the use of growth data to screen for silent disease in children has been the subject of lengthy debate, but there have been few cohort studies on which to judge its effectiveness, and consensus guidelines for referral have yet to emerge. Much of the debate currently relies on evidence from the Wessex growth study, which since 1986 has monitored a cohort of very short children in the …

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