EHRs detect growth disorders better

The use of algorithms integrated into electronic health records (EHRs) in the primary care setting better detects growth disorders in children than traditional monitoring of linear growth, according to a new population-based cohort study.

Researchers from Finland conducted a prospective 1-year study in which they collected growth data from 2008 to 2009 and analyzed it using their new automated growth monitoring (AGM) strategy integrated into an EHR and compared it with growth data collected from the preceding 3 years (2005-2008), which was analyzed using traditional methods.

Although monitoring of linear growth with growth charts has been a part of primary care practice for years, many growth disorders are diagnosed late. Experts believe that earlier diagnosis could facilitate more effective treatment.

The researchers’ AGM system includes analysis of growth data and referral of abnormal data for review by pediatric endocrinologists, in addition to standard growth monitoring. Although a specialist reviews abnormal data externally, the decision of whether to pursue secondary care still rests in the hands of the primary care physician.

The researchers calculated than an average of 33,029 children were screened per year during the control years, with an average of 4 children diagnosed with a new growth disorder per year. With the new automated system, the number of new diagnoses was 28 out of 32,404 children screened. The rate of diagnosis was 0.1 per 1,000 children screened during the control years versus 0.9 per 1,000 during the single AGM year.

The investigators cautioned that they do not know whether their findings would be duplicated in other countries, but that their system was associated with better, earlier detection of primary and secondary growth disorders in Finland. 

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