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Table 1 Seven auxological referral criteria taken from the Dutch Consensus Guideline [3].

From: The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines

Description rule   Criteria Rule nr.
Absolute height   HSDS* < -2.5 1
Clinical symptoms   HSDS* < -1.3 AND (dysmorphic features OR disproportions) 2
Persistent short stature after born SGA**   SGA** AND HSDS* < -1.88 after the age of 2 years 3
Short for target height and population (HSDScorr) ♂: < 10 yr and > 13.4 yr; HSDS* < -1.3 AND HSDS-THSDS§ < -1.3 4
  ♀: < 9 yr and > 12.3 yr   
  Pubertal age:
♂: 10 – 13.4 yr;
♀: 9 – 12.3 yr
HSDS* < -1.3 AND HSDS-THSDS§ < -1.3 AND pubertal signs (♂: genit ≥ Tanner stage 2 OR testis volume ≥ 4 ml; ♀: breast ≥ Tanner stage 2) 5
Height deflection ♂: < 10 yr and > 13.4 yr; ♀: < 9 yr and > 12.3 yr T2 – T1 > 1
(SDS1 – SDS2)/(T2-T1) < -0.25 OR (SDS1 – SDS2) < -1
6
  Pubertal age:
♂: 10 – 13.4 yr; ♀:
9 – 12.3 yr
T2 – T1 > 1
(SDS1 – SDS2)/(T2-T1) < -0.25 OR (SDS1 – SDS2) < -1 With pubertal signs
7
  1. * HSDS = Height Standard Deviation Score (Height – mean height for the same age and sex/SD for the same age and sex)
  2. **SGA = Small for gestational age
  3. § THSDS= Target Height Standard Deviation Score (Target height = (height of mother (+height of father +13) + 4.5)/2)
  4. Height deflection: Height deflection is formulated as Delta HSDS < -0.25 per year OR a delta HSDS <-1SDS over a longer period (not specified).
  5. Pubertal age: When a child does not show any pubertal signs (♂: genit ≥ Tanner stage 2 OR testis volume ≥ 4 ml; ♀: breast >= Tanner stage 2) at this age referral is not necessary.