Measures of Pediatric Growth

Transcription

1 Measures of Pediatric Growth Karen Mendez New York Medical College United Health Foundation/National Medical Fellowships Diverse Medical Scholars Program

2 Introduction MS1 at New York Medical College Conducted this study to: Learn more about the demographics and population characteristics of my new community in New York Acquire more experience and skills in conducting clinical research Improve the health outcomes of an underserved population

3 Background Organization selected for the study was Sound Shore Medical Center in New Rochelle, New York which became part of the Montefiore Hospital System during the course of the project. Site was a pediatric outpatient clinic located within the hospital that serves a diverse and mostly underserved patient population. Initial objective of this study was to assess the correlation between blood indices and childhood growth patterns. Target population was composed of underserved pediatric patients.

4 Methodology A literature search was conducted to identify current methods of evaluating growth as well as to find data on the diagnostic value of blood indices including those tested by a complete blood count (CBC). Patients were examined during regular well child visits and their weight and height were tracked. Body Mass Index was also calculated, per the equation weight (kg) / [height (m)] 2.

5 Results The literature search yielded support for the current growth curves developed by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Although certain blood indicators such as growth hormone and specific growth factors may be used to diagnose health issues affecting growth, standard values measured by the Complete Blood Count (CBC) do not appear to be an effective screening tool for issues associated with growth. Plotting stature, weight, and head circumference are simple and inexpensive methods to detect fluctuations and track development. The current algorithm of the growth chart takes into account the variation in growth velocity during different childhood stages as well as racial diversity of the population for which the chart is intended. A potential new direction would be to customize the growth chart for each patient based on genetic make up or to advocate for the development of more growth charts targeted at special populations.

6 Conclusion/Discussion The project had to be modified because there was difficulty securing IRB approval through the research site. Despite support from the site mentor, we were faced with numerous administrative hurdles, including ownership change of the hospital, elimination of the institutional Review Board (IRB), and lack of new protocol. Although I continued examining patients and measuring height and weight, the bulk of the project became a literature search. The goal was to conduct a review of current measures of pediatric growth and examine data on the value of blood indices as a diagnostic tool for growth deviations. The application has been submitted for review and we are pending approval through the Montefiore System. For any future project I would invest more time in getting to know the partnering agency to ensure that there are resources to review and support the study.

7 References Source U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, County Business Patterns, Economic Census, Survey of Business Owners, Building Permits, Census of Governments. Last Revised: Thursday, 27-Mar :56:47 EDT Swanson, MD, MBE, FAAP, W. S. (2014, March 6). How to Read a Growth Chart: Percentiles Explained. Retrieved from Pediatric Physical Examination Core Curriculum Appendices. Retrieved from WHO Growth Standards Are Recommended for Use with Children Younger Than Aged 2 Years in the United States. Retrieved from x.htm

8 Acknowledgements Sound Shore Medical Center/Montefiore New Rochelle Lisa Marrero, MD Site Mentor Daniel Pomerantz, MD Director of Ambulatory Care United Health Foundation National Medical Fellowships