title: Use of growth charts in Canada: A National Canadian Paediatric Surveillance Program survey.
abstract: BACKGROUND
  In 2010, the WHO Growth Charts for Canada were recommended for use in Canada, while the US Centers for Disease Control and Prevention (Georgia, USA) charts remained in active use.
  
  
  OBJECTIVE
  To assess the availability, utilization of and satisfaction with growth charts in clinical practice in Canada.
  
  
  METHODS
  In October 2012, a one-time survey was sent through the Canadian Paediatric Surveillance Program (CPSP) to 2544 paediatricians and 280 family physicians with a stated interest in paediatrics.
  
  
  RESULTS
  The response rate was 24% (63% general paediatricians, 36% subspecialists, 1% family physicians). Of these respondents, 68% preferred the WHO charts for infants and 49% for children and youth. Regarding the WHO charts, 49.7% of respondents reported concerns with their inability to assess weight for children >10 years of age, and many believed that there were too few percentile lines between the third and 97th percentiles for infant (24%) and for child and youth measures (19%). The addition of extreme percentiles (0.1 and 99.9), shading on charts and lack of availability with electronic medical record providers were other concerns mentioned by 10% to 13% of respondents.
  
  
  CONCLUSIONS
  There is support for the use of the WHO data for monitoring the growth of Canadian children. Concerns regarding the design of the charts were raised. These survey results lend support to the redesign of the WHO Growth Charts for Canada, as was recently completed in 2014.
authors.affiliation: Pediatrics, University of Ottawa, Ottawa, Ontario;
authors.forename: Sarah
authors.initials: S
authors.lastname: Lawrence
authors.affiliation: Pediatrics, Dalhousie University, Halifax, Nova Scotia;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cummings
authors.affiliation: Pediatrics, University of British Columbia, Vancouver, British Columbia;
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Chanoine
authors.affiliation: Pediatrics, University of British Columbia, Vancouver, British Columbia;
authors.forename: Daniel
authors.initials: D
authors.lastname: Metzger
authors.affiliation: Pediatrics, University of Toronto, Toronto, Ontario;
authors.forename: Mark
authors.initials: M
authors.lastname: Palmert
authors.affiliation: Pediatrics and Child Health, University of Manitoba;
authors.forename: Aul
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Pediatrics, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Celia
authors.initials: C
authors.lastname: Rodd
keywords: Body mass index; CDC; CPEG; Growth charts; WHO; Weight-forage