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Re: [Gnumed-devel] Introduction / growth standards

From: richard terry
Subject: Re: [Gnumed-devel] Introduction / growth standards
Date: Mon, 10 Jun 2002 22:50:29 +1000

Thanks for your reply. 

We'd love all contributions. I've quickly browsed you mail but not read it in 
detail as I'm laboring away on the GUI code!, but will attempt to do so in 
the near future. 

If you don't hear from anyone, don't disappear. 

Jump right in and send your contributions/information and they can be added 
to the CVS at some spot or other. Horst or Ian Haywood or others can add 
stuff to the CVS. Also, I think there is somewhere in gnumed for 
papers/documents. If you post a request to this mail list, whoever is doing 
that will pick it up

On Mon, 10 Jun 2002 21:24, you wrote:
> Hi,
> i'm a computer science student and working for more than 3 years now
> in the medical area.
> I've been programming a lot in C and Perl and some dead or already
> funny-smelling languages, but also in Java and C++.
> I did some work at the children's hospital in Leipzig, where we have
> a project called "CrescNet" where pediatrians send in length
> and weight data of their children an get an automatic response
> about their normality. At the moment 120'000 children with
> more than 250'000 length and weight measurements are in the database.
> Furthermore i'm doing work together with Micheal Hermanussen,
> concentrating on Synthetic normcurves (= constructing normcurves
> from little information) and growth patterns, giving an answer
> to the question: What growth development is normal? that
> goes far beyond the classical growth velocity centiles.
> I would like to see the entire question of growth standards
> cooperated into gnumed, and would be happy to contribute in that
> area.
> In Leipzig, and in a proprietary Program I co-wrote and finally
> in an website I'm working on (, where
> you can already get nice PDF-graphics for growth development
> of children according to different (well, 2 right now) standards),
> we do it the following way:
> - We have different normcurves, containing:
>   - mean and standard deviation of height for each sex and
>     several age points, assuming a normal distribution (which
>     is not quite true during puberty)
>   - L, M, and S according to the LMS-method by Tim Cole
>     (Box-Cox transformation for skew normal distributions)
>     for weight and BMI, again at several age points for each sex
> - Furthermore we have common growth patterns, calculated via
>     cluster analysis from about 800 children with complete
>     longitudinal data (the well known children from the
>     Prader, Sempe, Berkeley etc. studies), published earlier
>     by Micheal Hermanussen and now refined by me and probably
>     presented at a confrerence on auxology in november in
>     Gl├╝cksburg, Germany
> It is fairly easy to calculate L, M and S from centile data,
> and i've done that already, becauso many -- esp. older --
> studies don't contain them: Centile data alone is not too
> useful, since you can only say: "well, this is above
> the 97. centile" or so, but it might be more interesting
> wether it is 2 or 2.5 SDS, especially if you look at the
> development.
> It shouln't be hard to get centile data, since there are
> numerous collections avaliable, for example in
> proprietary but free (like free beer this time :-)
> programs like GrowthAnalyzer or KSN, and I do
> also have some important standards here. Furthermore
> it should be possible for users to enter their own standards
> and while gnumed spreads we will soon have all
> important standards entered into it, right?
> Gee, this is getting long already, ok, I think the questions
> are:
> 1)How are such standards treated in gnumed (put in a database /
>   config file), what other concepts like standards for parameter
>   xy (head circumference, other medical stuff i have no idea
>   of (he, what standards do you actually use for things like
>   blood pressure. Does a physician just say: Well, that's high
>   or are the kind of centile tables)) should be trated within the
>   same framework
> 2)How should the checks be done
> 3)How should the results be presented to the user
> I feel very at home in points 2 and 3, since I wrote
> a C-program for that for the Leipzig childrens hospital,
> a Delphi-program for Micheal Hermanussen and a perl-program
> for the above-mentioned website. Python would fill a gap here :-)
> What are your opinions esp. on point 1) and do you think that
> whole subject is of any importance for gnumed? And is anybody
> already working on that?
> Kind regards,
>         Christof
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> Gnumed-devel mailing list
> address@hidden

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