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GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice

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Harvard

Binder, G, Reinehr, T, Ibáñez, L, Thiele, S, Linglart, A, Woelfle, J, Saenger, P, Bettendorf, M, Zachurzok, A, Gohlke, B, Randell, T, Hauffa, BP, Claahsen van der Grinten, HL, Holterhus, P-M, Juul, A, Pfäffle, R & Cianfarani, S 2019, 'GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice' Hormone research in paediatrics, bind 92, nr. 3, s. 150-156. https://doi.org/10.1159/000503783

APA

Binder, G., Reinehr, T., Ibáñez, L., Thiele, S., Linglart, A., Woelfle, J., ... Cianfarani, S. (2019). GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice. Hormone research in paediatrics, 92(3), 150-156. https://doi.org/10.1159/000503783

CBE

Binder G, Reinehr T, Ibáñez L, Thiele S, Linglart A, Woelfle J, Saenger P, Bettendorf M, Zachurzok A, Gohlke B, Randell T, Hauffa BP, Claahsen van der Grinten HL, Holterhus P-M, Juul A, Pfäffle R, Cianfarani S. 2019. GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice. Hormone research in paediatrics. 92(3):150-156. https://doi.org/10.1159/000503783

MLA

Vancouver

Author

Binder, Gerhard ; Reinehr, Thomas ; Ibáñez, Lourdes ; Thiele, Susanne ; Linglart, Agnès ; Woelfle, Joachim ; Saenger, Paul ; Bettendorf, Markus ; Zachurzok, Agnieszka ; Gohlke, Bettina ; Randell, Tabitha ; Hauffa, Berthold P ; Claahsen van der Grinten, Hedi L ; Holterhus, Paul-Martin ; Juul, Anders ; Pfäffle, Roland ; Cianfarani, Stefano. / GHD Diagnostics in Europe and the US : An Audit of National Guidelines and Practice. I: Hormone research in paediatrics. 2019 ; Bind 92, Nr. 3. s. 150-156.

Bibtex

@article{a6d63e63789b424eb119e965cca62d77,
title = "GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice",
abstract = "INTRODUCTION: Almost 20 years after the first international guidelines on the diagnosis and treatment of GHD have been published, clinical practice varies significantly. The low accuracy of endocrine tests for GHD and the burden caused by ineffective treatment of individual patients were strong motives for national endocrine societies to set up national guidelines regarding how to diagnose GHD in childhood. This audit aims to review the current state and identify common changes, which may improve the diagnostic procedure.METHODS: A group of eight German pediatric endocrinologists contacted eight pediatric endocrinologists from Spain, France, Poland, the UK, the Netherlands, Denmark, Italy, and the US. Each colleague responded as a representative for the own country to a detailed questionnaire containing 22 open questions about national rules, guidelines, and practice with respect to GHD diagnostics and GH prescription. The results were presented and discussed in a workshop and then documented in this study which was reviewed by all participants.RESULTS: National guidelines are available in 7 of 9 countries. GH is prescribed by pediatric endocrinologists in most countries. Some countries have established boards that review and monitor prescriptions. Preferred GH stimulation tests and chosen cutoffs vary substantially. Overall, a trend to lowering the GH cutoff was identified. Priming is becoming more popular and now recommended in 5 out of 9 countries; however, with different protocols. The definition of pretest-conditions that qualify the patient to undergo GH testing varies substantially in content and strictness. The most frequently used clinical sign is low height velocity, but definition varies. Height, IGF-1, and bone age are additional parameters recommended in some countries.CONCLUSIONS: GHD diagnostics varies substantially in eight European countries and in the US. It seems appropriate to undertake further efforts to harmonize endocrine diagnostics in Europe and the US based on available scientific evidence.",
keywords = "Cutoff, Growth hormone deficiency, Growth hormone stimulation test, Guidelines, Priming",
author = "Gerhard Binder and Thomas Reinehr and Lourdes Ib{\'a}{\~n}ez and Susanne Thiele and Agn{\`e}s Linglart and Joachim Woelfle and Paul Saenger and Markus Bettendorf and Agnieszka Zachurzok and Bettina Gohlke and Tabitha Randell and Hauffa, {Berthold P} and {Claahsen van der Grinten}, {Hedi L} and Paul-Martin Holterhus and Anders Juul and Roland Pf{\"a}ffle and Stefano Cianfarani",
note = "{\circledC} 2019 S. Karger AG, Basel.",
year = "2019",
doi = "10.1159/000503783",
language = "English",
volume = "92",
pages = "150--156",
journal = "Hormone Research in Paediatrics",
issn = "1663-2818",
publisher = "S.Karger AG",
number = "3",

}

RIS

TY - JOUR

T1 - GHD Diagnostics in Europe and the US

T2 - An Audit of National Guidelines and Practice

AU - Binder, Gerhard

AU - Reinehr, Thomas

AU - Ibáñez, Lourdes

AU - Thiele, Susanne

AU - Linglart, Agnès

AU - Woelfle, Joachim

AU - Saenger, Paul

AU - Bettendorf, Markus

AU - Zachurzok, Agnieszka

AU - Gohlke, Bettina

AU - Randell, Tabitha

AU - Hauffa, Berthold P

AU - Claahsen van der Grinten, Hedi L

AU - Holterhus, Paul-Martin

AU - Juul, Anders

AU - Pfäffle, Roland

AU - Cianfarani, Stefano

N1 - © 2019 S. Karger AG, Basel.

PY - 2019

Y1 - 2019

N2 - INTRODUCTION: Almost 20 years after the first international guidelines on the diagnosis and treatment of GHD have been published, clinical practice varies significantly. The low accuracy of endocrine tests for GHD and the burden caused by ineffective treatment of individual patients were strong motives for national endocrine societies to set up national guidelines regarding how to diagnose GHD in childhood. This audit aims to review the current state and identify common changes, which may improve the diagnostic procedure.METHODS: A group of eight German pediatric endocrinologists contacted eight pediatric endocrinologists from Spain, France, Poland, the UK, the Netherlands, Denmark, Italy, and the US. Each colleague responded as a representative for the own country to a detailed questionnaire containing 22 open questions about national rules, guidelines, and practice with respect to GHD diagnostics and GH prescription. The results were presented and discussed in a workshop and then documented in this study which was reviewed by all participants.RESULTS: National guidelines are available in 7 of 9 countries. GH is prescribed by pediatric endocrinologists in most countries. Some countries have established boards that review and monitor prescriptions. Preferred GH stimulation tests and chosen cutoffs vary substantially. Overall, a trend to lowering the GH cutoff was identified. Priming is becoming more popular and now recommended in 5 out of 9 countries; however, with different protocols. The definition of pretest-conditions that qualify the patient to undergo GH testing varies substantially in content and strictness. The most frequently used clinical sign is low height velocity, but definition varies. Height, IGF-1, and bone age are additional parameters recommended in some countries.CONCLUSIONS: GHD diagnostics varies substantially in eight European countries and in the US. It seems appropriate to undertake further efforts to harmonize endocrine diagnostics in Europe and the US based on available scientific evidence.

AB - INTRODUCTION: Almost 20 years after the first international guidelines on the diagnosis and treatment of GHD have been published, clinical practice varies significantly. The low accuracy of endocrine tests for GHD and the burden caused by ineffective treatment of individual patients were strong motives for national endocrine societies to set up national guidelines regarding how to diagnose GHD in childhood. This audit aims to review the current state and identify common changes, which may improve the diagnostic procedure.METHODS: A group of eight German pediatric endocrinologists contacted eight pediatric endocrinologists from Spain, France, Poland, the UK, the Netherlands, Denmark, Italy, and the US. Each colleague responded as a representative for the own country to a detailed questionnaire containing 22 open questions about national rules, guidelines, and practice with respect to GHD diagnostics and GH prescription. The results were presented and discussed in a workshop and then documented in this study which was reviewed by all participants.RESULTS: National guidelines are available in 7 of 9 countries. GH is prescribed by pediatric endocrinologists in most countries. Some countries have established boards that review and monitor prescriptions. Preferred GH stimulation tests and chosen cutoffs vary substantially. Overall, a trend to lowering the GH cutoff was identified. Priming is becoming more popular and now recommended in 5 out of 9 countries; however, with different protocols. The definition of pretest-conditions that qualify the patient to undergo GH testing varies substantially in content and strictness. The most frequently used clinical sign is low height velocity, but definition varies. Height, IGF-1, and bone age are additional parameters recommended in some countries.CONCLUSIONS: GHD diagnostics varies substantially in eight European countries and in the US. It seems appropriate to undertake further efforts to harmonize endocrine diagnostics in Europe and the US based on available scientific evidence.

KW - Cutoff

KW - Growth hormone deficiency

KW - Growth hormone stimulation test

KW - Guidelines

KW - Priming

U2 - 10.1159/000503783

DO - 10.1159/000503783

M3 - Journal article

VL - 92

SP - 150

EP - 156

JO - Hormone Research in Paediatrics

JF - Hormone Research in Paediatrics

SN - 1663-2818

IS - 3

ER -

ID: 58341743