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Castlemead Growth Program II.
  1. DAVID H SKUSE, Professor of behavioural sciences

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    Castlemead Growth Program II. Compiled and written for Castlemead Publications by the MRC Dunn Nutritional Laboratory, University of Cambridge, 1994. Available from Castlemead Publications, 12 Little Mundells, Welwyn Garden City, Herts AL7 1EW; price £475 + VAT.

    The objective of this innovative software, the Castlemead Growth Program, was to provide a readily accessible system of recording growth data for computerised visual display. With the aid of the program it should be possible to dispense with paper growth charts altogether, and to generate data files that can be exported for statistical analyses by other programmes. The potential clinical benefits to the busy practitioner are considerable.

    The program was originally released in two versions. Program I was aimed at a broad medical market, such as general practitioners, and restricted to the recording of weight, height, and head circumference data; this has now been discontinued. The more advanced version, program II, which is aimed at a specialist market, has other features too. These include the capacity to record other measurements (for example, leg length, triceps and subscapular skinfolds, Turner’s syndrome height, Down’s syndrome height and weight and body mass index). It is also possible to analyse growth parameters with a variety of growth standards and to import and export data files from other software packages such as SPSS or Microsoft Excel. Program II is supplied with the new Buckler-Tanner British Clinical Longitudinal Growth Standards (1995) for height and weight.

    We have been using the specialist version of the software in a variety of research projects since its release in 1993.Accordingly, we should by now be familiar with its functions and idiosyncrasies. Yet we still approach any task that involves more advanced functions than simple data entry with trepidation. The manual supplied with the program gives the user limited information and is not at all clearly written. Although a telephone support service is supposed to be available we have persistently met with limited success in finding anybody able to advise us. The usual response is that the ‘adviser’ is unable to help with anything other than the most basic functions of the program. Furthermore, when colleagues visited the suppliers they were extremely disappointed at the lack of knowledge of those demonstrating the program’s capacities.

    Even our research staff who are highly computer literate have encountered difficulties in using this arcane system. For example, when setting up a data file a number of different record fields need to be created, and these vary depending on the growth measures wanted. Each of the records (for example, composite record, primary record, and growth standards) needs to be linked. Yet the manual provides little insight into how to go about this task. Although it should be possible to transfer data and to import and export growth data created in ASCII format elsewhere, this relatively straightforward task took a student, already very familiar with the program, a number of days to complete.

    Once a file is set up and data have been entered it is possible to generate a variety of graphical representations of your data, either in SD scores or centiles. Printing the information is rather more difficult. Despite having tried at least four different printers we still experience problems printing growth charts; the printer interface certainly does need revision. When it works though, the results are wonderful!

    Despite all the drawbacks, once one is familiar with its idiosyncracies the program is an invaluable tool for anybody seriously concerned with the measurement of growth in children. For example, the computation of SD scores for a variety of anthropometric measures, including body mass index, saves an inordinate amount of time when compared with calculating these measures by hand. The variety of ways in which growth charts may be printed is also a potentially valuable resource. To summarise, this is extremely valuable but still expensive software—which takes some persistence to master.