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After waiting 20 years for the evidence that growth monitoring is not only effective but also cost effective, you will understand how much I welcome the papers by Fayter et al1 and Grote et al.2 Both have declared, yet again, that the early identification and referral of children with abnormal growth is beneficial and that a good monitoring system is required. If only the papers had been available in 1998 when a meeting of health professionals took place in Coventry and virtually dismantled any form of monitoring system in the United Kingdom. Having considered that growth hormone deficiency and Turner syndrome were the only two conditions worth measuring for in the absence of evidence to the contrary, the meeting concluded with a “consensus” that routinely measuring children was not worth it. This month’s papers have turned that on its head, with Grote’s study specifying at least four groups of patients with growth disorders and Fayter confirming that new cases of a number of other conditions may be identified as a consequence of height screening. In fact, the Coventry Consensus – as the gathering is now famously called – heard of 14 conditions for which monitoring was a diagnostic aid but ignored the majority of them.3
We will never know how many children – abnormally tall as well as abnormally short – may have had their futures permanently compromised by the Consensus but now, having the evidence, we should make sure that the minimalist monitoring protocol arrived at in Coventry is replaced. The protocol is enshrined in Health for all children 4e and the National service framework for children and is not worth the paper it is written on.4 5 Neither document …
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