title: A comparison of referral patterns to the pediatric endocrine clinic before and after FDA approval of growth hormone for idiopathic short stature.
abstract: BACKGROUND
  Short stature is a common reason for referral to the pediatric endocrine clinic. In 2003, the US Food and Drug Administration (FDA) approved the use of growth hormone (GH) for the treatment of children with idiopathic short stature (ISS).
  
  
  OBJECTIVE
  To explore if this indication changed referrals for short stature (SS).
  
  
  METHODS
  A retrospective chart review of children seen for SS in the pediatric endocrine clinic between July 1998 and June 1999 (interval one, n=138) and July 2005-June 2006 (interval two, n=268) was performed. Variables collected included age, gender, height (h), and parental heights.
  
  
  RESULTS
  Average height standard deviation score (HT-SDS) was -2.11 +/- 0.9 in interval one and -2.14 +/- 0.83 in interval two (p=ns). No differences in age, gender distribution, relationship between child and parental heights, the proportion of subjects started on GH for ISS or in the HT-SDS of those treated between the two intervals were identified. Nearly half of all children referred in each interval did not meet the technical criteria for short stature.
  
  
  CONCLUSIONS
  No differences in referral patterns for SS in our area following FDA approval of GH for ISS were identified. Although referrals appear unchanged, additional investigation of GH prescribing patterns before and after this new indication is needed. Continued education of primary care physicians and the general public regarding the definition of SS and the eligibility for GH therapy should be pursued.
authors.affiliation: Section of Pediatric Endocrinology and Diabetology, Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA. agoldyn@iupui.edu
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Goldyn
authors.forename: Zeina M
authors.initials: ZM
authors.lastname: Nabhan
authors.forename: Erica A
authors.initials: EA
authors.lastname: Eugster
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000502:physiology; D002648:Child; D017277:Drug Approval / Q000331:legislation & jurisprudence; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence
chemical_list: D019382:Human Growth Hormone