Disease-specific growth charts--do we need them?

A physician’s training and experience leads him to follow a particular path when confronted with a problem. The complaints are discussed, the history is taken, symptoms are investigated, the diagnosis is made, treatment is recommended and, finally, the prognosis is given. When the patient’s problems are related to growth, there is no reason to take a different approach. The medical pathway, however, is never one-dimensional. Like any hormonally regulated metabolic pathway, there is feedback interaction and interdependence between various factors. The situation is made even more complex when time is taken into consideration. In view of such a complex situation, the question of whether disease-specific growth charts (DSGCs) are needed requires a more sophisticated answer than yes or no. The exact nature of the role that disease-specific growth charts may play in the interactional process from presentation to prognosis needs to be considered.