Thakrar A, Taylor E M, Wales J K
St. George's Hospital, Sheffield.
J Public Health Med. 1994 Jun;16(2):200-4. doi: 10.1093/oxfordjournals.pubmed.a042957.
To assess the value of the Middlesex-Height Velocity Screening Chart (based on the 50th velocity percentile +/- 1 SD) as a means of screening for abnormal growth in children, the heights of children at seven infant schools were measured on two separate occasions at least 12 months apart. A total of 229 children of mid-age (age of the child between the two measurements) ranging from 4.5 to 6.8 years were measured. Height velocity standard deviation score was calculated for each child by comparison with current Tanner-Whitehouse standards. The subjects were children who had a height recorded during the school entrant medical at least 12 months before the date of the second height measurement. The height velocity standard deviation score calculated for each child was related to the limits set by the Middlesex Screening Chart, and these criteria were used to determine whether or not the child had a 'normal' growth rate. It has been recommended that those falling outside these limits are referred for further assessment. It was found that 95 (41 percent) children fell outside the 'normal' range on the Middlesex chart (66 growing faster and 29 slower), which, if the guidelines were used uncritically, would result in the possible referral of 2500 5-6-year-olds in Sheffield alone. Taking into consideration the additional problems inherent in making two accurate height measurements from which a height velocity could be calculated, and the high number of referrals that would be generated as demonstrated by this study, height velocity screening for growth disorders using current methods is not feasible.
为评估米德尔塞克斯身高速度筛查图表（基于第50百分位速度±1标准差）作为筛查儿童生长异常手段的价值，对7所幼儿园儿童的身高进行了两次测量，两次测量间隔至少12个月。共测量了229名年龄介于4.5至6.8岁之间的儿童（两次测量期间的年龄）。通过与当前坦纳 - 怀特豪斯标准比较，计算出每个儿童的身高速度标准差分数。研究对象为在第二次身高测量日期前至少12个月入学体检时有身高记录的儿童。为每个儿童计算的身高速度标准差分数与米德尔塞克斯筛查图表设定的界限相关，这些标准用于确定儿童的生长速度是否“正常”。建议将超出这些界限的儿童转介做进一步评估。结果发现，95名（41%）儿童的身高超出了米德尔塞克斯图表上的“正常”范围（66名生长较快，29名生长较慢），如果不加批判地使用这些指导方针，仅在谢菲尔德就可能导致2500名5至6岁儿童被转介。考虑到进行两次准确身高测量以计算身高速度所固有的额外问题，以及本研究所示的高转介数量，使用当前方法进行生长障碍的身高速度筛查并不可行。
