Theoretical Growth Evaluation (TGE)

Abstract

A computerized screening system for growth disorders is presented. Its aim is to save time and to facilitate the decision of whether a patient with a suspected growth problem should be referred for specialized evaluation. It uses accepted methods and common sense, and has been shown to be effective. A radiography of the hand and wrist, and a completed data sheet (birth date, date of x-ray, height and weight, parental height, and in girls, whether menarche has occurred) are mailed for analysis. Bone age is rated according to Greulich and Pyle, and Tanner et al. by trained technicians, and the results are supervised by a consultant pediatric endocrinol ogist. The supplied data and bone age values are then processed by a computer, which compares them with normal values, calculates three different height predictions (Bayley and Pinneau, Roche et al., Tanner et al.), as well as "target height" (estimation of genetic potential), and prints an easy-to-read growth curve. Depending on the constellations of height (normal, below 3rd, above 97th percentile), bone age (normal, retarded, advanced in comparison with chronologic age), and height predictions vs. target height (predictions within, below, above target height range), different messages suggesting the most likely diagnostic possibilities are listed on a computer printout.