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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Variation in methods of predicting adult height for children with idiopathic short stature.
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Variation in methods of predicting adult height for children with idiopathic short stature.

机译：特发性矮小儿童的成人身高预测方法的差异。

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OBJECTIVE: Recombinant human growth hormone (GH) is approved for treatment of children with idiopathic short stature, and endocrinologists often depend on algorithms to predict adult height. Because algorithm performance often is included in treatment decisions, we sought to evaluate agreement among height prediction formulas. METHODS: We identified 3 commonly used algorithms for height prediction, the Bayley-Pinneau, Roche-Wainer-Thissen, and Khamis-Roche methods. We constructed simulated samples of children with typical distributions of ages, heights, weights, bone ages, and parental heights seen in patients with idiopathic short stature, and we applied the algorithms to the simulated sample to determine whether predicted adult height was <160 cm for boys or <150 cm for girls (<1.2nd height percentiles for adults). RESULTS: We found substantial disagreement among algorithms in the proportions of simulated cases with predicted adult heights of <1.2nd percentile, a cutoff value that may influence GH treatment decisions. With the Bayley-Pinneau formula, 43% of boys and 81% of girls had predicted adult heights below this threshold; with the Khamis-Roche method, only 3% of boys and 0.2% of girls had predicted heights of <1.2nd percentile. Roche-Wainer-Thissen predictions were between those values. Overall agreement of the methods was poor (kappa = 0.21) for boys and negative for girls. CONCLUSIONS: Wide variation exists among formulas used to predict adult heights. Because these algorithms may be used in decisions regarding whether to initiate GH treatment and assessment of the efficacy of GH in research trials, it is important for parents, pediatricians, and investigators to recognize the considerable variation involved in height predictions.
机译：目的：重组人生长激素（GH）已被批准用于治疗特发性矮小儿童，内分泌学家通常依靠算法来预测成人身高。由于算法性能通常包含在治疗决策中，因此我们试图评估身高预测公式之间的一致性。方法：我们确定了三种常用的高度预测算法：Bayley-Pinneau，Roche-Wainer-Thissen和Khamis-Roche方法。我们构建了患有特发性矮小患者的典型年龄，身高，体重，骨龄和父母身高分布儿童的模拟样本，并将算法应用于模拟样本，以确定预测的成年人身高是否<160 cm男孩或女孩<150厘米（成人<1.2身高百分位数）。结果：我们发现，在预测成人身高<1.2％的模拟病例比例中，算法之间存在很大分歧，该临界值可能影响GH治疗决策。根据Bayley-Pinneau公式，预测有43％的男孩和81％的女孩的成人身高低于此阈值;使用Khamis-Roche方法时，只有3％的男孩和0.2％的女孩预测的身高<1.2％。 Roche-Wainer-Thissen的预测介于这些值之间。对于男孩，这些方法的总体一致性较差（kappa = 0.21），对于女孩则为阴性。结论：用于预测成人身高的公式之间存在很大差异。由于这些算法可用于决定是否开始进行GH治疗以及在研究试验中评估GH的功效，因此对于父母，儿科医生和研究者来说，认识到身高预测中的巨大差异非常重要。

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