Mash et al developed a classification tree for evaluating a child who is showing a failure to thrive. This can help to distinguish true failure to thrive from medical (non-physical) abuse and neglect. The authors are from the Cleveland Clinic and Children's Hospital Cleveland.
Patient selection: child < 5 years of age with failure to thrive
Parameters:
(1) number of organ systems involved
(2) serious congenital anomaly and/or confirmed genetic disorder
(3) number of reported allergies
(4) response to referral to a feeding team
Number of Organ Systems Involved |
Response to Referral |
Congenital or Genetic Disorder |
Number of Allergies |
Percent Medical Abuse (Risk) |
0 to 4 |
accept |
NA |
NA |
0% (low) |
0 to 4 |
refuse |
NA |
NA |
50% (intermediate) |
5 or more |
NA |
yes |
0 to 4 |
0% (low) |
5 or more |
NA |
yes |
5 or more |
75% (high) |
5 or more |
NA |
no |
NA |
93% (high) |
Performance in study population:
• The tree was 100% sensitive and 96% specific (for low vs intermediate or high risk.
Specialty: Clinical Laboratory, Emergency Medicine, Pedatrics