Predictive Value of IAP 2015, IAP 2007 and WHO Growth Charts in Identifying Pathological Short Stature

Abstract

Objective: To compare the diagnostic accuracy of IAP 2015, WHO and IAP 2007 growth charts in identifying pathological short stature in Indian children.

Methodology: The predictive value of the growth charts for pathological short stature was assessed in 500 (266 boys) short subjects (age 5-17.9 years) presenting to our pediatric endocrine clinic.

Results: WHO, IAP 2015, IAP 2007 criteria classified 500, 410 (82%) and 331 (66.2%) subjects short respectively. A total of 218 (43.6%) subjects had a pathological cause. Two out of 90 subjects short by WHO criteria but normal as per IAP 2015 had a pathological cause (2.2%) whereas 38 out of 79 subjects short as per WHO and IAP 2015 criteria but normal by IAP 2007 had pathological short stature. The diagnostic measures of IAP 2015 and IAP 2007 charts in identifying pathological short stature showed a sensitivity 99.1% and 81.7%, negative predictive value 97.8% as against 76.3%, positive predictive value 52.7% and 53.8%, and specificity of 31.2% and 45.7%, respectively.

Conclusion: IAP 2015 growth charts are superior in identifying pathological growth failure compared to WHO and IAP 2007.