pediatric-growth-assessment

Pediatric Growth Assessment

Overview

Retrieve longitudinal height, weight, and head circumference Observations for a pediatric patient. Calculate age- and sex-specific percentiles and z-scores using WHO standards (0-2 years) and CDC growth charts (2-20 years). Assess growth velocity, BMI-for-age, and weight-for-length (under 2 years). Flag percentile crossing (shift of 2+ major percentile lines), failure to thrive criteria, obesity, and short stature triggers. Generate a structured growth assessment with referral recommendations when indicated.

FHIR Resources Used

Resource	Purpose	Key Fields
Patient	Age, sex, birth date	birthDate, gender
Observation	Height, weight, head circumference, BMI	code, valueQuantity, effectiveDateTime
Condition	Known growth-related diagnoses	code, clinicalStatus, onsetDateTime
MedicationRequest	Growth hormone, nutritional supplements	medicationCodeableConcept, status

Instructions

Step 1: Retrieve Patient Demographics

Tool: fhir_read
resourceType: "Patient"
id: "[patient-id]"

Extract birthDate (calculate exact age in years, months, days), gender (required for sex-specific charts). Confirm age is 0-20 years. If older than 20, this skill does not apply.

Step 2: Pull All Growth Observations

Tool: fhir_search
resourceType: "Observation"
queryParams: "patient=[patient-id]&code=29463-7,8302-2,9843-4,8287-5,39156-5&_sort=date&_count=200"

LOINC codes:

• 29463-7 = Body weight
• 8302-2 = Body height (standing)
• 8306-3 = Body height lying (recumbent length, used <2 years)
• 9843-4 = Head occipitofrontal circumference
• 8287-5 = Head circumference percentile
• 39156-5 = BMI

Also search for recumbent length separately if child is under 2:

Tool: fhir_search
resourceType: "Observation"
queryParams: "patient=[patient-id]&code=8306-3&_sort=date&_count=50"

For each Observation, extract:

• effectiveDateTime -- calculate age at measurement
• valueQuantity.value and valueQuantity.unit -- normalize to metric (kg, cm)
• Convert lbs to kg (* 0.453592), inches to cm (* 2.54) if needed