One study was included, assessing 1,370 Dutch children aged three to 10 years.
This study concluded that the distance to target height was the most important criterion. In combination with the other criteria, the sensitivity was 85.7% for identifying girls with Turner’s syndrome and 76.5% for identifying those with short stature due to pathology. The false-positive rate was 1.5% to 1.9%.
Two strategies were modelled; one a simplification of the Dutch study criteria (height below more than two standard deviations less than the mean, for referral), and the other based on UK consensus (height at school entry, 0.4th centile or less on UK 1990 charts, for referral).
The UK strategy was less effective and less costly, with a mean gain of 0.001 quality-adjusted life-years (QALYs) at a mean cost of £21. The Dutch strategy was more expensive and more effective, with a mean cost of £68 and a mean gain of 0.042 QALYs. The incremental cost per QALY gained with the Dutch strategy was £1,144.