Digital technologies to improve the precision of paediatric growth disorder diagnosis and management. (August 2021)

• Record Type: Journal Article
• Authors: Dunkel, Leo; Fernandez-Luque, Luis; Loche, Sandro; Savage, Martin O.
• Is Part Of: Growth hormone & IGF research. Volume 59(2021)
• Publication Date: 2021-08
• Subjects: Electronic connected device -- Digital health -- Digital technology -- eHealth -- Growth hormone -- Growth disorders -- Medical informatics -- Paediatrics; AI artificial intelligence -- AM automated monitoring -- AR augmented reality -- ECOS easypod Connect Observational Study -- GH growth hormone -- HCP healthcare providers -- hGH human growth hormone -- HVSDS height velocity standard deviation score -- ICT information and communication technologies -- IGF insulin-like growth factor -- IT information technology -- OECD Organisation for Economic Co-operation and Development -- RR risk ratio -- SDS standard deviation score -- WHO World Health Organisation; Growth regulators -- Periodicals; Growth -- Regulation -- Periodicals; Somatomedin -- Periodicals; Somatomedins -- Periodicals; Growth Hormone -- Periodicals; Growth Substances -- Periodicals; Croissance -- Régulation -- Périodiques; Croissance -- Régulateurs -- Périodiques; Somatotrophine -- Périodiques; Somatomédine -- Périodiques; Growth -- Regulation; Growth regulators; Electronic journals; Periodicals; Electronic journals; 612.4
• DOI: 10.1016/j.ghir.2021.101408
• Languages: English
• ISSNs: 1096-6374

Abstract

Abstract: Paediatric disorders of impaired linear growth are challenging to manage, in part because of delays in the identification of pathological short stature and subsequent referral and diagnosis, the requirement for long-term therapy, and frequent poor adherence to treatment, notably with human growth hormone (hGH). Digital health technologies hold promise for improving outcomes in paediatric growth disorders by supporting personalisation of care, from diagnosis to treatment and follow up. The value of automated systems in monitoring linear growth in children has been demonstrated in Finland, with findings that such a system is more effective than a traditional manual system for early diagnosis of abnormal growth. Artificial intelligence has potential to resolve problems of variability that may occur during analysis of growth information, and augmented reality systems have been developed that aim to educate patients and caregivers about growth disorders and their treatment (such as injection techniques for hGH administration). Adherence to hGH treatment is often suboptimal, which negatively impacts the achievement of physical and psychological benefits of the treatment. Personalisation of adherence support necessitates capturing individual patient adherence data; the use of technology to assist with this is exemplified by the use of an electronic injection device, which shares real-time recordings of the timing, date and dose of hGH delivered to the patient with the clinician, via web-based software. The use of an electronic device is associated with high levels of adherence to hGH treatment and improved growth outcomes. It can be anticipated that future technological advances, coupled with continued 'human interventions' from healthcare providers, will further improve management of paediatric growth disorders. Highlights: Growth disorders impact on patients and their families. Delays in diagnosis and treatment negatively affect outcomes. Digital interventions improve growth monitoring and data analysis. Such technology can improve adherence to human growth hormone therapy. Education of patients/caregivers may also be positively impacted.