Is routine detailed screening tests in healthy children necessary?

Year 2019, Volume: 13 Issue: 2, 177 - 182, 18.06.2019

Derya Kalyoncu

https://doi.org/10.21763/tjfmpc.430406

Abstract

Background: The aim of the study was to determine if routine
detailed screening tests in healthy children are needed or not. Methods: A total of 590 healthy
children (mean age: 9.7±2.9 years, M/F: 286/304) who were referred from primary
care providers for screening tests were evaluated retrospectively in terms of
laboratory findings such as complete blood count, lipid profiles, liver and
kidney function tests.  Results: Iron deficiency anemia was
significantly more common in teenage girls than boys. Only 16.7% of girls and
16.4% of boys had lipid abnormalities. The other biochemical parameters were
within normal limits in both groups. Conclusions:
No significant difference was observed in biochemical parameters in healthy
children. Thus, unnecessary tests should not be done in healthy children by
primary care physicians.

Amaç:
Çalışmanın amacı sağlıklı çocuklarda rutin ayrıntılı tarama testlerine gerek
olup olmadığını değerlendirmektir. Gereç
ve yöntem: Çalışmaya aile hekimleri tarafından tarama testlerinin yapılması
için tarafımıza yönlendirilen 590 sağlıklı çocuk (ortalama yaş: 9.7±2,9 yıl,
E/K:286/304) alınmıştır. Çalışılan test sonuçları (tam kan sayımı, lipit
düzeyleri, karaciğer ve böbrek fonksiyon testleri, tiroid testleri)
retrospektif olarak değerlendirilmiştir. Bulgular:
Demir eksikliğine bağlı anemi ergen kız çocuklarında erkeklere oranla daha sık
saptanmıştır. Lipit bozuklukları kızlarda %16,7, erkeklerde %16,4 oranında
saptanmıştır. Diğer biyokimyasal parametreler normal tespit edilmiştir.  Sonuç:
Sağlıklı çocuklarda ayrıntılı biyokimyasal testler açısından istatistiksel
olarak anlamlı patoloji saptanmamıştır. Bu nedenle, maliyet de düşünüldüğünde
aile hekimleri tarafından gereksiz testler istenilmemeli ve bu konuda aile
hekimleri bilgilendirilmelidir.

Keywords

Healthy children, screening tests, biochemical tests

References

• 1. Minkovitz C, Wissow L. Evaluating and using laboratory tests. In: Oski's Pediatrics. Principles and Practice, 4th, McMillan JA, Feigin RD, DeAngelis C, Jones MD (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p.95.
• 2. The Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 May. Clinical Summaries of Recommendations for Children and Adolescents. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235850. Accessed date: 05.05. 2018.
• 3. U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services 2010 - 2011: Recommendations of the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56707/ Accessed date:01.05.2018.
• 4. The Guide to Clinical Preventive Services 2012: Recommendations of the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Oct. Recommendations for Children and Adolescents. Available from: https://www.ncbi.nlm.nih.gov/books/NBK115119/ Accessed date: 3.05.2018.
• 5. Simon GR, Baker C, Barden GA III, et al. 2014 recommendations for pediatric preventive health care. Pediatrics. 2014;133(3):568–570.
• 6. Committee on Practice and Ambulatory Medicine, Bright Futures Periodicity Schedule Workgroup/American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care - Periodicity Schedule. Pediatrics. 2017;139(4). pii: e20170254. doi: 10.1542/peds.2017-0254. www.aap.org/en-us/professional-resources/practice-support/Pages/PeriodicitySchedule.aspx Pediatrics 2017 Accessed date:04.05.2018.
• 7. Bright Futures Steering Committee. Bright Futures guidelines for health supervision of infants, children, and adolescents. Middle childhood. http://brightfutures.aap.org/pdfs/Guidelines_PDF/17-Middle_Childhood.pdf. Accessed date: 04.05.2018.
• 8. Geoffrey R Simon, Cynthia Baker, Graham A Barden 3rd, Brown OW, Hardin A, Lessin HR, Meade K, Moore S, Rodgers CT; Committee on Practice and Ambulatory Medicine, Curry ES, Dunca PM, Hagan JF Jr, Kemper AR, Shaw JS, Swanson JT; Bright Futures Periodicity Schedule Workgroup. 2014 recommendations for pediatric preventive health care. Pediatrics. 2014;133(3):568-70. doi: 10.1542/peds.2013-4096.
• 9. Behrman RE, Kliegman RM, editors:Nelson Essentials of Pediatrics, 4th edition, Philadelphia, 2002, WB Saunders, chapter 1;2-4 pp.
• 10. Levine D. Evaluation of the Well Child section 2 Growth and Development, Nelson Essentials of Pediatrics, 6th edition, Philadelphia, 2006, WB Saunders, chapter 9 ;24-28 pp.
• 11. Neyzi O, Ertuğrul T, Pediatri Cilt 1. Gökçay G, Neyzi O, Bulut A, Sağlam Çocuk İzlemi, Nobel Tıp Kitabevi.2002; 3: 49-56.
• 12. Özdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Pediatri Ars. 2015; 50(1):11-9.
• 13. World Health Organization. Iron deficiency anaemia assessment, prevention, and control. A guide for programme managers. Geneva (Switzerland): World Health Organization; 2001, pp 114.
• 14. Koyuncuoğlu Güngör N. Overweight and Obesity in Children and Adolescents. Journal of Clinical Research in Pediatric Endocrinology. 2014;6(3):129-143. doi:10.4274/jcrpe.1471.
• 15. Leuridan E, Van Damme P. Hepatitis B and the need for a booster dose. Clin Infect Dis. 2011;53(1):68-75.
• 16. Schillie S, Murphy TV, Sawyer M, et al. CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management. Morb Mortal Wkly Rep Recomm Rep 2013;62;1-19.
• 17. Grossman DC, Moyer VA, Melnyk BM, Chou R, DeWitt TG; U.S. Preventive Services Task Force. The anatomy of a U.S. Preventive Services Task Force recommendation: lipid screening for children and adolescents. Arch Pediatr Adolesc Med. 2011;165(3):205–210.
• 18. Lin KW. What to Do at Well-Child Visits: The AAFP's Perspective. Am Fam Physician. 2015 ;91(6):362-4.
• 19. Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN Clinical Practice Guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr 2017;64:319‐334.
• 20. Mitnikos T, Kohli R. Pediatric nonalcoholic fatty liver disease. Clin Liver Dis. 2018;11(4):95-97.
• 21. National Heart, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011;128 (Suppl. 2011;128(Suppl 5):213–256.
• 22. American Academy of Family Physicians. Summary of recommendations for clinical preventive services. July 2014. https://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/cps-recommendations.pdf. Accessed date: 02.05.2018.
• 23. Gür E, Yıldız I, Celkan T. Prevalence of anemia and the risk factors among school children in İstanbul. J Trop Pediatr. 2005;51:346-50.