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Overtesting and inadequate management of 25-hydroxyvitamin D status in paediatric secondary and tertiary care
  1. Justin Huw Davies1,2,
  2. Molly Handcock2,
  3. Paul Cook3,
  4. Olivia Kaye3,
  5. Rebecca Jane Moon1,4
  1. 1Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Faculty of Medicine, University of Southampton, Southampton, UK
  3. 3Clinical Biochemistry, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
  1. Correspondence to Dr Rebecca Jane Moon, MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; rm{at}

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Vitamin D is essential for bone health and has uncertain roles in other health outcomes. In the UK, universal supplementation with 400 IU/day vitamin D is recommended during autumn and winter and throughout the year for groups at risk of vitamin D deficiency (VDD).1 Vitamin D status can be assessed by serum 25-hydroxyvitamin D (25(OH)D) concentration, but national guidance from the Royal Osteoporosis Society (ROS) recommends against routine testing in children without clinical indication.2 However, 25(OH)D testing has dramatically increased in the UK3 and at our centre from 1136 tests/year in children (2013) to 3898 (2020).

We assessed adherence to the ROS guidance on indications for 25(OH)D testing (shown in table 1) and the management of the result in children within secondary and tertiary care at our children’s hospital. Data were collected retrospectively from full clinical records review during November–December 2021 for all children who had 25(OH)D assessed during consecutive 14-day periods in January (n=139) …

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  • Contributors JHD developed the methodology, interpretation of the findings and critical revision of the manuscript. MH collected data, performed the analysis and revised the manuscript. PC contributed to data collection and critical review of the manuscript. OK contributed to data collection and critical review of the manuscript. RJM conceived the study, developed the methodology, data collection, performed analysis, drafted and revised the manuscript. All authors approved the final submitted manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RJM received travel bursaries from Kyowa Kirin. JHD received travel bursaries from Novo Nordisk and honoraria from Kyowa Kirin.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.