Growth monitoring for short stature: update of a systematic review and economic model


Assessment of a child's height and weight is well established as an indicator of their general health and well-being. Growth monitoring is potentially useful for the increased detection of height-related disorders and secondary pick-up of other diagnosed conditions. However, for children of primary school age, the exact role of growth monitoring and the optimal strategies to adopt are currently unclear. The aim of this assessment was to compare different screening rules and/or referral cut-offs for the identification of children with disorders of short stature by updating a systematic review and economic model.


Only one study on referral for short stature in children of primary school age which met the inclusion criteria for the review was identified. The strategy for referral considered in this study was then used to inform one of the two strategies considered in the economic model. The other strategy was based on UK consensus. The lack of evidence identified was reflected in all aspects of this research. We found a lack of evidence on appropriate referral strategies, quality of life and utility gains in this population and no evidence linking gains in height to health related quality of life. The research contributes further knowledge, but provides no definitive answers on how to deliver growth monitoring. In particular, it was impossible to evaluate an optimal referral cut-off and age at which to screen. A number of research questions that would further inform referral strategies were identified, which in summary would involve further primary and secondary data collection.

Conducted by: CRD

Further details

Project page on NIHR HTA Programme website


Craig D, Fayter D, Stirk L, Crott R. Growth monitoring for short stature: update of a systematic review and economic model. Health Technol Assess 2011;15(11)


Commissioned by the NIHR HTA Programme as part of the Technology Assessment Report (TAR) process