000065313 001__ 65313 000065313 005__ 20200117211557.0 000065313 0247_ $$2doi$$a10.3389/fendo.2017.00374 000065313 0248_ $$2sideral$$a104189 000065313 037__ $$aART-2018-104189 000065313 041__ $$aeng 000065313 100__ $$aMaghnie, M. 000065313 245__ $$aShort stature diagnosis and referral 000065313 260__ $$c2018 000065313 5060_ $$aAccess copy available to the general public$$fUnrestricted 000065313 5203_ $$aThe "360° GH in Europe" meeting, which examined various aspects of GH diseases, was held in Lisbon, Portugal, in June 2016. The Merck KGaA (Germany) funded meeting comprised three sessions entitled "Short Stature Diagnosis and Referral, " "Optimizing Patient Management, " and "Managing Transition." Each session had three speaker presentations, followed by a discussion period, and is reported as a manuscript, authored by the speakers. The first session examined current processes of diagnosis and referral by endocrine specialists for pediatric patients with short stature. Requirements for referral vary widely, by country and by patient characteristics such as age. A balance must be made to ensure eligible patients get referred while healthcare systems are not over-burdened by excessive referrals. Late referral and diagnosis of non-GH deficiency conditions can result in increased morbidity and mortality. The consequent delays in making a diagnosis may compromise the effectiveness of GH treatment. Algorithms for growth monitoring and evaluation of skeletal disproportions can improve identification of non-GH deficiency conditions. Performance and validation of guidelines for diagnosis of GH deficiency have not been sufficiently tested. Provocative tests for investigation of GH deficiency remain equivocal, with insufficient information on variations due to patient characteristics, and cutoff values for definition differ not only by country but also by the assay used. When referring and diagnosing causes of short stature in pediatric patients, clinicians need to rely on many factors, but the most essential is clinical experience. 000065313 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000065313 590__ $$a3.634$$b2018 000065313 591__ $$aENDOCRINOLOGY & METABOLISM$$b48 / 145 = 0.331$$c2018$$dQ2$$eT2 000065313 592__ $$a1.344$$b2018 000065313 593__ $$aEndocrinology, Diabetes and Metabolism$$c2018$$dQ1 000065313 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000065313 700__ $$0(orcid)0000-0003-2832-2266$$aLabarta, J.I.$$uUniversidad de Zaragoza 000065313 700__ $$aKoledova, E. 000065313 700__ $$aRohrer, T.R. 000065313 7102_ $$11010$$2670$$aUniversidad de Zaragoza$$bDpto. Pediatría Radiol.Med.Fís$$cÁrea Pediatría 000065313 773__ $$g8, JAN (2018), Art. 374 [7 pp]$$pFront. endocrinol.$$tFrontiers in Endocrinology$$x1664-2392 000065313 8564_ $$s187191$$uhttps://zaguan.unizar.es/record/65313/files/texto_completo.pdf$$yVersión publicada 000065313 8564_ $$s103830$$uhttps://zaguan.unizar.es/record/65313/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000065313 909CO $$ooai:zaguan.unizar.es:65313$$particulos$$pdriver 000065313 951__ $$a2020-01-17-21:09:13 000065313 980__ $$aARTICLE