Choosing Wisely:

Avoid ordering screening tests looking for chronic illness or an endocrine cause, including complete blood count, cytidine monophosphate , insulinlike growth factor 1, thyroid tests, and celiac antibodies, in healthy children who are growing at or above the 3rd percentile for height with a normal growth rate (i.e., not crossing percentiles) and with appropriate weight gain.

Rationale and Comments: Even in children who are below the 3rd percentile for height with a normal history and physical exam, the incidence of newly diagnosed pathology was found to be only about 1%. In patients who have significant short stature (e.g. ≤ –2.5 standard deviation) or who are well below their genetic potential based on parental heights, tiered or sequential screening may be considered.
Sponsoring Organizations:
  • American Academy of Pediatrics – Section on Endocrinology
  • Sources:
  • Expert consensus
  • Disciplines:
  • Endocrinologic
  • Pediatric
  • References: • Sisley S, Trujillo MV, Khoury J, Backeljauw P. Low incidence of pathology detection and high cost of screening in the evaluation of asymptomatic short children. J Pediatr. 2013 Oct;163(4):1045-51.

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