Early detection of growth disorders with the CrescNet system at the Leipzig treatment center

Abstract

Background: Growth hormone replacement therapy is more effective the earlier it is begun. This article adresses the question whether children with growth hormone deficiency (GHD) were able to begin treatment earlier through the use of the CrescNet system in the Department of Pediatrics at the Leipzig University Hospital. CrescNet is a network of pediatricians and endocrinological treatment centers, established in Leipzig in 1998, whose aim is to improve the early detection of growth disorders.

Methods: Pediatricians participating in CrescNet provided anonymized data on their patients' height and weight to the CrescNet database. Each participating pediatrician received a quarterly screening report with recommendations for the work-up of children with abnormal growth. Some patients with GHD who were treated in the Leipzig treatment center were referred in response to these recommendations, while others came spontaneously from the practices of pediatricians participating or not participating in CrescNet. We determined the age at the onset of treatment for the 139 patients treated for GHD in the University Children's Hospital Leipzig from 1999 to 2005 and compared the findings with data from other treatment centers in Germany.

Results: Patients from CrescNet practices began treatment at a younger age than those from non-CrescNet practices (8.77 ± 3.40 versus 9.50 ± 3.78 years, p = 0.26). Patients from CrescNet practices whose GHD was detected by screening began treatment earlier than those for whom no data had been sent (7.67 ± 3.21 versus 9.28 ± 3.39 years, p = 0.031). In the center in Leipzig, but not in other German GHD treatment centers, the age at onset of treatment dropped significantly over the period of the study and then remained steady till 2009 in the range of 7.61 ± 3.0 years.

Conclusion: These descriptive results imply that the linking of pediatricians' practices with the CrescNet system resulted in earlier treatment of children with GHD.

Figures

Figure 1

The box plots show the median values of the age at the start of therapy according to the standards between 1999 and 2005 with the 1st and 3rd quartiles and the highest and lowest individual value; the circle indicates the arithmetic mean. The drop in the median value in the patients with growth hormone deficiency between 1999 and 2005 in the Leipzig center is clear

Figure 2

Drop in the age at the start of therapy in the Leipzig patients o not a CrescNet partner; o CrescNet partner without screening; o CrescNet partner with screening; x weighted mean of the other treatment centers for comparison