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      Patient Attitudes and Preferences Regarding Treatment: GH Therapy for Childhood Short Stature

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          This paper examines the role of parents’ attitudes and preferences regarding growth hormone therapy for childhood short stature. Four main questions are addressed. First, what are the demographic characteristics of families seeking medical advice for their child’s short stature? Second, what are parents’ attitudes towards short stature? Third, what are parents’ treatment preferences (i.e. what characteristics of growth treatments are important to parents)? Finally, how do the attitudes of parents affect physician decision making? Several studies are reviewed and data are presented to answer these questions.

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          Most cited references 3

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          Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited

           R Rosenfeld (1995)
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            HEALTH CARE POLICY:Outcomes Research: Measuring the End Results of Health Care

             C M Clancy (1998)
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              Ethical issues in growth hormone therapy.

              Pediatricians face clinical and ethical dilemmas about therapy to augment growth in short children who do not meet classic criteria for growth hormone (GH) deficiency. Biologic norms of health are unhelpful because of the uncertain relationship between stature, GH secretion, health, and disease. Instead, we suggest that GH therapy be evaluated from the perspective of cultural norms. We compare GH therapy for short normal children with currently accepted therapies for non--life-threatening pediatric conditions such as well-child care, cosmetic therapy, treatment of psychological problems, and invasive outpatient therapy for chronic conditions. Based on this analysis, we argue that the burdens of therapy, the uncertainty about long-term risks and benefits, the unclear therapeutic end point, and the implications for child health policy place routine GH therapy for children without documented deficiency of GH secretion outside current pediatric ethical norms. Such therapy is properly administered within a comprehensive clinical research protocol.

                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                June 1999
                17 November 2004
                : 51
                : Suppl 1
                : 67-72
                aDepartments of Pediatrics, bMarketing and cBanking and Finance, dEpidemiology and Biostatistics and ePharmacology, Case Western Reserve University, Cleveland, Ohio, USA
                53138 Horm Res 1999;51(suppl 1):67–72
                © 2004 S. Karger AG, Basel

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                Page count
                Tables: 3, References: 25, Pages: 6
                Evidence-Based Medicine


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