08 Nov 2021
New app helps parents identify treatable childhood growth disorders earlier
A ground-breaking new, mobile phone app, ‘GrowthMonitor’ places the accurate measurement of children’sheight in the hands of parents and carers. Preliminary data presented at the Society for Endocrinology annual conference in Edinburgh suggests that the app could reliably identify treatable growth disorders, much earlier, with significant improvements in child health.
Childhood growth is a strong indicator of health and well-being in children, but delays in the diagnosis of growth disorders are common in the UK. In contrast to many European health systems, monitoring child growth has not been a priority in the UK and serious, treatable conditions are often diagnosed late. Growth failure may be the first and only sign of many chronic childhood diseases or indicate a specific growth disorder such as growth hormone deficiency (1 in 4,000 children), Noonan and Turner syndrome (each 1 in 2,500 children) and SHOX deficiency (up to 20% of undiagnosed short stature).
A reliable and accurate method for parents and carers to monitor growth at home could be a cost-effective and convenient strategy to identify those children in need of medical referral, empowering parents, raising awareness and reducing pressure on primary care services.
An interdisciplinary group, led by Professor Helen Storr, at Queen Mary University London, has developed a user-friendly app called ‘GrowthMonitor’ to do just this. Research Nurse, Dr Thilipan Thaventhiran, led the pilot testing of the ‘GrowthMonitor’ app in 79 children, showing that height data measured by the app were highly accurate when compared to gold standard clinic stadiometer measurements. The app uses a simple traffic light system, based on predetermined threshold heights, to inform parents that growth is either normal (green), to continue monitoring (amber) or to seek medical advice (red).
Dr Thaventhiran believes “The ‘GrowthMonitor’ app technology could transform our approach to childhood growth monitoring, by empowering carers to identify growth problems early, enabling much earlier diagnosis and treatment of growth disorders. It could also provide reassurance to parents whose children are growing normally thereby reducing unnecessary anxiety and referrals to paediatric services.”
Following the positive pilot data obtained in a hospital setting, further testing is now underway assessing the app’s usability in the home environment. This phase is critical in evaluating the app in the hands of parents and carers, away from the hospital.
Project lead, Professor Storr says; “In line with the government drive to digitise healthcare, this type of app-based technology provides a model for healthcare innovation which is both cost-effective, convenient, accurate and reliable. Engaging patients, parents and carers in monitoring childhood growth is empowering and raises awareness of important and potentially treatable conditions”
Development and testing of a novel ‘GrowthMonitor’ Smartphone App for growth monitoring and the detection of growth disorders
Thilipan Thaventhiran1, Vincent Harding2, Anne Hsu1, Leo Dunkel1, Paul Chapple1, Helen Storr1
1Queen Mary University London, QMUL, London, United Kingdom. 2University College London, UCL, London, United Kingdom
Background. Childhood growth is an indicator of health/well-being. Growth monitoring identifies treatable conditions in apparently healthy children and prevents inappropriate referrals. Systematic growth monitoring is not currently a UK priority and growth disorders are frequently diagnosed late.
Objective. Develop and test the accuracy of GrowthMonitor, an app which enables families to measure a child’s height at home as a cost-effective alternative to primary care growth monitoring.
Methods. ‘GrowthMonitor’ calculates height data using augmented reality. Patients were measured by the app in parallel to stadiometer (gold standard) height measurements as part of routine care. The coefficient of variance assessed repeatability/precision of 3 consecutive app measurements for each patient. Linear regression evaluated the relationship between the app and stadiometer measurements to determine accuracy. The app uses novel algorithms that calculate height compared to UK population-based height references (HSDS), distance from target height (THSDSDEV) and HSDS change over time (ΔHSDS). Predefined cut-offs trigger green (normal), amber (monitor) or red (seek medical advice) alerts.
Results. A total of 79 (42M) patients participated with mean±SD age 10.37±4.1 yr (range 1.9-18.0). The average coefficient of variance for the app measurements was 1.5%, indicating excellent precision. Linear regression showed a clear linear relationship between the app and stadiometer measurements (R2 0.99; p<0.0001). A Bland-Altman plot gave a bias constant of 0.298, suggesting no consistent bias of either height measurement approach. Of the 12/79 (15%) individuals that triggered red alerts in the app (recommending referral), only 2 (2.5%) were incorrect. According to corresponding stadiometer measurements, these should have triggered amber alerts. One ‘normal’ app measurement was in the amber range according to the stadiometer measurement.
Conclusion. Our preliminary data suggest that the GrowthMonitor app produces accurate, reliable height measurements. This technology could transform the approach to growth monitoring and facilitate early referral/diagnosis of growth disorders.
Learn more at www.qmul.ac.uk/growth-monitor
This work was funded by the Grant for Growth Innovation (GGI) and Barts Charity.