Development and validation of a mobile application for point of care evaluation of growth failure

Riddhi V. Patel; Anurag T. Bajpai; Hemangkumar V. Mendpara; Chetankumar C. Dave; Sajili S. Mehta; Shalabh Dixit; Rishi K. Shukla

doi:10.1515/jpem-2021-0267

Article

Development and validation of a mobile application for point of care evaluation of growth failure

Riddhi V. Patel , Anurag T. Bajpai , Hemangkumar V. Mendpara , Chetankumar C. Dave , Sajili S. Mehta , Shalabh Dixit and Rishi K. Shukla

Published/Copyright: September 17, 2021

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 35 Issue 2

Abstract

Objectives

Lack of systematic evaluation of short stature results in unnecessary work-up on one hand while missing pathology on the other. We have developed a mobile application that guides work-up based on age, auxology (height, BMI, and corrected standard deviation score), and skeletal maturation with an aim of reducing the diagnostic errors. Aim of this study is to develop and validate a mobile application for point of care evaluation of short stature.

Methods

The application was developed (n=400) and validated (n=412) on children and adolescents (2–18 years of age) presenting to our Pediatric Endocrinology Clinic with short stature. Height standard deviation score thresholds determining the need for workup were derived from Receiver Operating Characteristics (ROC) curve. Student’s t-test and ROC curves were used to identify the most appropriate parameter differentiating constitutional delay of growth and puberty (CDGP) from pathological and nutritional from endocrine causes. The validation of the application involved comparing the application predicted and clinical diagnosis at each step of the algorithm.

Results

The mobile application diagnosis was concordant with clinical diagnosis in 408 (99.0%) with discordance in four (two with CDGP labeled as growth hormone deficiency [GHD] and two with GHD labeled as CDGP).

Conclusions

Mobile application guided short stature assessment has a high concordance with the clinical diagnosis and is expected to help point of care short stature evaluation.

Keywords: algorithm; mobile application; validation

Corresponding author: Dr. Anurag Bajpai, MD, Pediatrics, FRACP Pediatric Endocrinology, Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, Opposite PPN Market, Kanpur 208001, India; and GROW Society, Growth & Obesity Workforce, Kanpur, India, Mobile: +919936737767, E-mail: dr_anuragbajpai@yahoo.com

Acknowledgments

We would like to thank Dr. Vaman Khadilkar for providing a Macro template for calculating Z scores asper IAP 2015 criteria.

Research funding: Not funded.
Author contributions: Riddhi V. Patel, Hemangkumar V. Mendpara, Chetankumar C. Dave, and Sajili S. Mehta were involved in patient management and data collection. Riddhi V. Patel did a literature review, statistical analysis and drafted the initial manuscript. Rishi K. Shukla and Anurag T. Bajpai were involved in patient care. Salabh Dixit developed and tested the mobile application. Anurag T. Bajpai conceptualized and planned the study, designed the application, critically reviewed the manuscript, and would act as the guarantor of the paper. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was approved by the Institutional Ethics Committee of our hospital (RHL-IEC-16039, September 11, 2019).

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Received: 2021-04-12

Accepted: 2021-09-03

Published Online: 2021-09-17

Published in Print: 2022-02-23

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https://doi.org/10.1515/jpem-2021-0267

Keywords for this article

algorithm; mobile application; validation