gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

17.09. - 21.09.2017, Oldenburg

Supporting Pediatricians Decision-Making by using CrescNet as Infrastructure

Meeting Abstract

  • Christoph Beger - Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Deutschland; Wachstumsnetzwerk CrescNet, Universitätsmedizin Leipzig, Leipzig, Deutschland
  • Ruth Gausche - Wachstumsnetzwerk CrescNet, Universitätsmedizin Leipzig, Leipzig, Deutschland
  • Rene Müller - Wachstumsnetzwerk CrescNet, Universitätsmedizin Leipzig, Leipzig, Deutschland
  • Roland Pfäffle - Klinik und Poliklinik für Kinder- und Jugendmedizin der Universität Leipzig, Leipzig, Deutschland

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS). Oldenburg, 17.-21.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocAbstr. 191

doi: 10.3205/17gmds133, urn:nbn:de:0183-17gmds1336

Published: August 29, 2017

© 2017 Beger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Introduction: Abnormal growth is a cardinal symptom. There are many disorders, which cause aberrant growth. This makes it hard to find out all correct diagnoses in early years of childhood development. To support primary care pediatricians in their decision-making and improve patient care overall, the growth network CrescNet [1] was founded in 1998. The main goal of this network is the detection of growth disorders and underlying diseases as early as possible. Currently CrescNet, led by Roland Pfäffle, M.D., Professor of pediatric gastroenterology and endocrinology, is located at the University Hospital of Leipzig and cooperates with approximately 300 pediatricians and endocrinologists in Germany, with focus on Saxony.

Methods: Over the last years, a successful workflow was established, which supports above mentioned goal. Independent physicians transmit growth data of their patients periodically and pseudonymously, extracted from the local patient data management system (PDMS). On receipt, the datasets are imported into a database management system. CrescNet receives a PDMS specific identifier, core data like birthdate, gender, gestational age and parental heights, as well as concrete measurements. Hence, CrescNet is not able to identify patients, because the re-identification is only possible by treating physicians. A screening program checks the database routinely for suspicious growth trends, by evaluating all documented measures over the past year and by comparing height, weight, body mass index and head girth with references published by Kromeyer-Hauschild et al. [2], Rosario et al. [3], Voigt et al. [4] and others. Furthermore the screening algorithm checks for variations over short time intervals, which may be caused by underling diseases (e.g. craniopharyngioma [5]). The complete functionality of the screening is out of scope of this publication. All patients detected with abnormal growth are submitted to and analyzed by a pediatric endocrinologist. Based on his assessment, a response is sent to the primary care pediatrician, with respective recommendations. If patients are referred to a specialist in course of the treatment, who is a partner of CrescNet, the specialist is able to use already documented data for diagnosis and treatment.

Results: In the year 2016, 193.854 new visits were documented (88.307 by independent pediatricians and 105.547 by treatment centers and clinics) and 116.433 patients were checked for an abnormal growth. Saliences were identified in 4.295 cases and in 1.132 cases a recommendation was issued. Those children may not have been identified without data collection and screening.

Discussion: Described scenario shows that consistent documented growth by measuring basal body dimensions like height and weight can be an early hint for serious or rare diseases. Currently exists no comparable program like CrescNet in Germany. Sankilampi et al. [6] compared the number of detected children with growth disorders in primary care in Finland with and without an automated growth monitoring (AGM) of electronic health records. They “showed that [AGM] was associated with a higher rate of detection and referral to specialist care” [6]. AGM is based on data of one facility, whereas the CrescNet infrastructure collects data from potentially multiple sources and allows pediatric experts to evaluate the documented measures.

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Die Autoren geben an, dass kein Ethikvotum erforderlich ist.


Hoepffner W, Pfäffle R, Gausche R, Meigen C, Keller E. Früherkennung von Wachstumsstörungen – System CrescNet im Behandlungszentrum Leipzig. Early detection of growth disorders with the CrescNet system at the Leipzig treatment center. Dtsch Arztebl Int. 2011;108(8):123-8.
Kromeyer-Hauschild K, Wabitsch M, Kunz D, et al. Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd. 2001;149:807.
Rosario AS, Schienkiewitz A, Neuhauser H. German height references for children aged 0 to under 18 years compared to WHO and CDC growth charts. Ann Hum Biol. 2014 Jul-Aug;41(4):381.
Voigt M, Fush C, Olbertz D, Hartmann K, Rochow N, Renken C, Schneider KTM. Analyse des Neugeborenenkollektivs der Bundesrepublik Deutschland. Geburtsh Frauenheilk. 2006;66:956-970.
Müller HL. Childhood craniopharyngioma--current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol. 2010 Nov;6(11):609-18.
Sankilampi U, Saari A, Laine T, et al. Use of Electronic Health Records for Automated Screening of Growth Disorders in Primary Care. JAMA. 2013;310(10):1071-1072.