Original Title: Efectividad, seguridad y evaluación económica de las diferentes alternativas existentes en la supervisión del crecimiento físico y desarrollo puberal

Authors' objectives: The aim of this review is to assess the available information related to the efficiency, effectiveness and security of the monitoring of growth and pubertal development in the paediatric population.

Authors' results and conclusions: There is a lack of empirical data on the effects of growth monitoring on child and adult health, with growth monitoring defined as serial measurements of weight, length/height, head and arm circumference. In addition, no evidence is available regarding the effectiveness, security and efficiency of routine monitoring of pubertal development using the Tanner scale. The literature search for efficiency studies identified two health technology assessments (HTA) that analyse an individual measurement at a single point in time: height screening at school entry. Both assessments suggest that height screening appears to be a cost-effective option. The literature search for effectiveness studies identified a Cochrane systematic review including one randomized controlled trial that found no differences between those allocated to growth monitoring and those not. The absence of an impact on nutritional status may reflect that the study was too small to detect a difference between the two groups. Experts recommend routine growth monitoring. They agreed that the potential benefits of growth monitoring include identification of chronic disorders and provision of reassurance to parents. There is no scientific evidence to assess the balance of benefits and harms of monitoring growth and pubertal development in children to detect growth related conditions. However, expert consensus agreed that growth must be monitored in all children.

Authors' recommendations: Measurement of weight, length, and head circumference to all children less than two years of age, in every health control, is suggested. Measurement of weight and height to all children older than two years of age, in every health control, is suggested.

Authors' methods: The following databases were searched: PubMed/MEDLINE, EMBASE, Lilacs; and the databases of the Centre for Reviews and Dissemination (CRD): NHS Economic Evaluation Database (NHS EED), Health Technology Assessment Database (HTA), Database of Abstracts of Reviews of Effects (DARE). In addition, the databases of the following government agencies and scientific societies were also searched: U.S. Preventive Services Task Force, Canadian Task Force on Preventive Health Care, American Academy of Pediatrics, American Association of Clinical Endocrinologists, UK National Screening Committee, Asociación Española de Pediatría, Asociación Española de Pediatría en Atención Primaria y Sociedad Española de Endocrinología y Nutrición. Subsequently, a manual search from the reference lists of previously identified references was conducted. Complete economic evaluation studies, experimental and observational studies with a comparison group published until April 2013, were selected for the review. No limits were applied for language. The selection of studies was done according to the previously defined inclusion and exclusion criteria. Those articles that met inclusion criteria were assessed by the computer-assisted critical appraisal tool of the Basque Office for Health Technology Assessment-OSTEBA.

Project Status: Completed

Year Published: 2016

URL for published report: https://www.iacs.es/wp-content/uploads/2017/04/752_IACS_Desarrollo-fisico-puberal.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Health Sciences Institute in Aragon (IACS)

Contact Address: Avda, San Juan Bosco, 13, planta 2

Contact Name: María Pilar Calvo Pérez

Contact Email: direccion.iacs@aragon.es