Correspondence (letter to the editor): Cooperation Should Not Be Stopped

Assessing growth and development is one of the most important tasks today’s pediatricians find themselves faced with (1). It is remarkable how many pediatricians with their own practices, and obviously also pediatric-endocrinologic centers, are ready to delegate this core competence to an outside supplier. The authors use their article (2) to advertise the services of CrescNet GmbH (Ltd). Some of their statements require correction. The comment that patients from practices participating in CrescNet are given growth hormone therapy earlier than patients from non-CrescNet practices does not hold true in view of the authors’ own statistical analysis (P=0.26) (2, 3). A comparison of the patients’ age at initiation of growth hormone treatment between the old German states and Leipzig before and after screening (Table 2) shows that in the old states, already at the beginning of the observation period 1999, the age at which treatment was started was as low as it was in Leipzig’s CrescNet practices six years after introduction of the screening. The mean values in Table 3 also show that the mean age for all centers in the old German states is notably below the mean age for CrescNet. Only the screening practices reached the values of the old German states. The statement should thus be modified to say that the implementation of a screening program in Leipzig successfully lowered the age at initiation of growth hormone therapy to the level held by the endocrinological centers in the old German states. In my opinion this does not justify for pediatricians with their own practices to give up cooperating with pediatric endocrinologists or their regional pediatric endocrinology centers.