The period in which child growth disorders can be treated is very limited. The CrescNet screening system aims to give paediatricians an additional security in the assessment of the growth and weight development of potential patients in need of treatment. Therefore, CrescNet maintains a differentiated feedback system to the data submitted.
In case parents want a second opinion in the assessment of their child's development of their child, CrescNet offers this free of charge. For this purpose a request form (available as digitally fillable document ) has been developed.
With CrescNet, cooperation between paediatricians and endocrinologists is promoted, who can apply for online access to the database. Through contact with CrescNet, targeted prevention measures can be offered and supported. (See also: Projektpartner)
The data obtained through the involvement of paediatric and adolescent practices allow the establishment of reference curves and the assessment of global developments. For example the development of the conspicuity rates of overweight (BMI > 90th percentile) and obesity (BMI > 97th percentile).
Who is involved so far?
Around 200 paediatricians and adolescent doctors and more than 30 paediatric endocrinology treatment centres in which growth disorders can be treated competently are involed in the network. The project is coordinated in Leipzig. Here, about 80% of the paediatricians in private practice participate in the network.
By 2022, measurements of growth and weight trends of almost one million children and adolescents have been registered in CrescNet.
You want to participate?
Sign a cooperation agreement with the CrescNet. It includes that you receive a subsidy for the purchase of a measuring device for accurate body height measurement. In return, CrescNet expects a transmission of the collected data.
What is measured and how?
Measurements of height, body weight and head circumference are taken in the practices under standardised conditions with quality-tested measuring devices. You can find information on the measurement methodology here: Measurement methodology . Preferably, the measured values of the screening examinations from U1 to U9 and J1. In addition, measurements are also collected on the occasion of a patient presentation for acute reasons. Furthermore, one-time data on parental variables are recorded, gestational age at birth, and, where applicable, information on ethnic origin and on a chronic disease (ICD 10) are recorded.
How is the data transmitted?
The collected data are sent pseudonymously to the database, which is kept and administered at the head office and is located at the Medical Computer Centre of Leipzig University Hospital. Documentation and transfer of the data are carried out according to regulations from 'Good Clinical Practice'.
The CrescNet API is intended to enable external partners to transfer patient data to the CrescNet growth network. The data is transferred to the CrescNet via an encrypted connection and persistently stored in the data centre of Leipzig University Medical Centre. In addition, the visualisations of the CrescNet (e.g. growth charts) can be called up with the API.
More information about this interface is available on request.
Since 2007, it has been possible to record data electronically via the CrescNet Client, a small program that is connected to the patient data management system via a standard interface (BDT/GDT).
Die Datenübermittlung nach Pseudonymisierung erfolgt quartalsweise über ein, durch die Universitätsmedizin Leipzig betriebenes, Datenaustauschsystem.
The other variant of electronic data transmission consists of an export module within already used physician software. For Turbomed there is a separate module with which pseudonymisation and export can be integrated directly into the practice software. The installation is done as an update of the practice software. We thank Turbomed for their kind support.
Please contact us for more information.
If you still keep hand files for your patients, there is the possibility to record the data in writing on blue and red tear-off cards, so-called barcode tickets, and send them to us by post (red cards for girls, blue for boys). The mailing material will be provided to you prepaid.
A barcode is assigned to each patient to ensure that the data is assigned to the correct child. The barcode strips are scanned at CrescNet.
In the facilities affiliated to the CrescNet, a clearly visible notice draws attention to the fact that in this practice all data for the early detection of growth disorders are sent pseudonymously to the CrescNet growth network in the Medical Faculty of the University of Leipzig. An information sheet displayed in the waiting area describes which data is collected, where it is stored and what is done with it.
If parents do not want this data to be transferred, they can clarify this directly with the paediatrician in charge. Data will then not be transmitted.
The address for deleting data that has already been recorded is also given in the information sheet. Data deletion can be done easily by sending an e-mail to firstname.lastname@example.org.
All measurements are subjected to plausibility checks. In addition, the measurement data is screened for abnormalities in growth and weight development at regular intervals. This screening is done electronically. A paediatrician specialising in paediatric endocrinology and diabetology assesses the measurement data of each abnormal child individually. The resulting screening report is sent to each practice at about 12-week intervals with recommendations for the next steps for clarification.
Request and referral
With further supplementary data, a written request can be sent to the network. For this purpose, a request form created by CrescNet is filled out and sent in together with a recent x-ray of the left hand. The information allows an analysis of the growth situation and, in most cases, the preparation of a growth forecast. The submitter receives an auxological report. This service is provided within the framework of the non-profit status.
In the case of serious abnormalities, CrescNet recommends a referral to the responsible treatment centre. Currently, 27 such centres or specialists in private practice are working together in CrescNet throughout Germany. The treatment centre should be located as close as possible to the patient's place of residence.
Indications for the use of growth hormone
For small stature diagnostics recognised auxological criteria are used. One cause of short stature can be a deficiency of growth hormone, so a growth hormone deficiency may need to be ruled out (Procedure to exclude a growth hormone deficiency). Recognised indications for therapy with growth hormone are currently isolated or combined growth hormone deficiency, small for gestational age infants (SGA), Ullrich-Turner syndrome and Prader-Willi-Labhart syndrome, as well as progressive growth retardation in chronic renal insufficiency.
Tall stature is less likely than short stature to be considered conspicuous and in need of treatment (see Self-assessed Quality of Life over height SDS ). The familial disposition plays a particularly important role in the anamnesis of a tall stature; the pregnancy and birth anamnesis can also provide decisive clues to understanding. A number of genetic tall stature syndromes are associated with an increased risk of other diseases; an exact genetic clarification is therefore justified in the case of such syndromal tall statures. In this context, especially the Differential diagnosis of high growth with prenatal onset, and also the Differential diagnosis of high growth with postnatal onset are of interest.