Correction to: Consensus and controversies about diagnosing GH deficiency: a Delphi survey by the GH research society (Pituitary, (2025), 28, 3, (57), 10.1007/s11102-025-01526-z)

In the original version of the article, errors were present in the reported degree of consensus in Table 1. Statement 1 ‘Children with growth deceleration with a deflection in height of at least 0.3 SDS/year, after exclusion of any other cause of poor growth. ‘. 97% of all panelists agreed with the statement (not 97% disagreed,” as incorrectly reported). Statement 5 ‘Short children with a history of being SGA who fail to demonstrate catch-up growth by 2 years of age should be evaluated for GHD. ‘. 84% of all panelists agreed with the statement. Subdivision revealed agreement by 80% of adult endocrinologists and 88% of pediatric endocrinologists (not disagreement, as the table erroneously indicated). The corrected version of Table 1 is provided below. Statements on diagnosing GH deficiency Total Adult endocrinologists Pediatric endocrinologists Whom to test – children 1. Children with growth deceleration with a deflection in height of at least 0.3 SDS/year, after exclusion of any other cause of poor growth 97% agreement 95% agreement 2. Children with a height ≥ -2SD (below the mean) 75% agreement 86% agreement 3. Children with an IGF-I SDS score of < -1 should be tested for GHD. 49% agreement 38% agreement 4. Neonates with persistent hypoglycemia and prolonged jaundice should be tested for GHD. 92% agreement 86% agreement 5. Short children with a history of being SGA and fail to demonstrate catch-up growth by 2 years of age should be evaluated for GHD. 84% agreement 80% agreement 6. Short children with obesity should be tested for GHD. 52% agreement 43% disagreement 7. Short children with two or more pituitary hormone deficiencies do not need GH stimulation testing as the likelihood of GHD is very high. 72% agreement 75% agreement 8. Short children with a CNS insult such as a brain or pituitary tumor, or brain irradiation, should be tested for GHD. 98% agreement 95% agreement 9. Children with uncontrolled or untreated hypothyroidism, adrenal insufficiency or hypogonadism should not be tested for GHD until replacement is adequate. 97% agreement 95% agreement 10. Short children who have a contra-indication to GH therapy, for example, an active malignancy, should not be tested for GHD. 75% agreement 95% agreement 11. Children with a diagnosis of GHD should always be evaluated with an MRI. 100% agreement 100% agreement 12. Patients without an antecedent history of pituitary or brain disease/injury, a genetic syndrome that causes hypopituitarism or childhood-onset GHD should not be tested for GHD. 64% agreement 50% agreement 13. Patients who have a contra-indication for GH therapy, for example, an active malignancy, should not be tested for GHD. 67% agreement 57% disagreement 14. Patients who state that they would not take GH replacement therapy should not be tested for GHD. 61% agreement 79% disagreement 15. Adults with childhood-onset isolated GHD who stopped GH therapy at epiphyseal closure should be retested for GHD. 94% agreement 86% agreement 16. Patients with pituitary or hypothalamic tumors or masses should be tested for GHD. 97% agreement 100% agreement 17. Patients with one or more of the following should be tested for GHD: central diabetes insipidus (AVP deficiency) secondary hypothyroidism, secondary hypoadrenalism and/or secondary hypogonadism. 100% agreement 100% agreement 18. Patients with lymphocytic or idiopathic hypophysitis should be tested for GHD. 94% agreement 100% agreement 19. Patients with checkpoint-inhibitor induced hypophysitis should not be tested for GHD. 56% agreement 36% agreement 20. Patients with uncontrolled diabetes, poorly controlled hypothyroidism, adrenal insufficiency or hypogonadism should not be tested for GHD until replacement therapy is adequate. 100% agreement 100% agreement 21. Patients with an IGF-I SDS score of > 0 should not be tested for GHD. 61% agreement 71% agreement 22. GH testing including IGF-I measurement should not be part of a screening exam for middle-aged or older patients as part of an “anti-aging” regimen. 100% agreement 100% agreement 23. Patients with panhypopituitarism and a low IGF-I level (<-2 SD) do not need testing for GHD as the likelihood of GHD is very high. 97% agreement 93% agreement 24. Patients with suspected GHD and a history of treated acromegaly should be tested for GHD. 92% agreement 100% agreement 25. Children who have been treated for isolated GHD should stop treatment and be retested after final adult height is achieved. 100% agreement 100% agreement 26. Patients should not be tested for GHD if they are critically ill or pregnant. 97% agreement 93% agreement 27. Patients with childhood-onset GHD should be retested after adult height is achieved and epiphyses are closed. 100% agreement 100% agreement 28. In patients undergoing pituitary surgery, GH testing must await adequate replacement of any additional pituitary hormone insufficiencies. 100% agreement 100% agreement 29. In patients with acromegaly, testing for GH deficiency should not be performed until at least 3–6 months after pituitary surgery to confirm remission from GH excess. 97% agreement 100% agreement 30. In patients who are currently taking GH, testing for GHD should not occur until the patient has stopped the GH therapy for at least 1–2 months. 100% agreement 100% agreement 31. Serum IGF-I levels is a useful screening test in children with short stature. 89% agreement 85% agreement 32. GHD can be confirmed only with GH provocative testing. 75% agreement 80% agreement 33. Two GH provocative tests should be performed in all children to diagnose GHD. 72% agreement 75% agreement 34. In patients with multiple pituitary hormone deficiencies, GH provocative testing is not required since the likelihood of GHD is very high. 89% agreement 95% agreement 35. Children with short stature and IGF-I SDS ≤- 2 do not require GH stimulation testing prior to beginning GH therapy. 84% disagreement 80% disagreement 36. The knowledge of the GH assays/standards used to measure GH is required for the interpretation of the measurement of GH. 97% agreement 100% agreement 37. All children with short stature during the peripubertal period should receive sex steroid priming prior to provocative GH testing. 65% agreement 60% agreement 38. The clonidine stimulation test is an excellent test to diagnose GHD in children. 40% agreement 37% disagreement 39. The insulin tolerance test is an excellent test to diagnose GHD in children. 63% agreement 74% agreement 40. The arginine stimulation test is an excellent test to diagnose GHD in children. 80% agreement 79% agreement 41. The glucagon stimulation test is an excellent test to diagnose GHD in children. 69% agreement 58% agreement 42. The macimorelin stimulation test is an excellent test to diagnose GHD in children. 26% agreement 32% agreement 43. Exercise is not an adequate stimulation test to diagnose GHD in children. 95% agreement 95% agreement 44. GH stimulation testing is necessary to make the de novo diagnosis of GHD in adults except for those patients with panhypopituitarism and a low serum IGF-I. 100% agreement 100% agreement 45. Insulin tolerance testing is the gold standard to test for GHD, but there are many contraindications. 100% agreement 100% agreement 46. Glucagon stimulation test is an excellent test for GHD in adults. 76% agreement 79% agreement 47. Macimorelin stimulation test is an excellent test for GHD in adults. 75% agreement 57% agreement 48. GHRH+arginine is an excellent stimulation test for GHD in adults, but GHRH is not available world-wide. 94% agreement 86% agreement 49. GHRH (as a single agent) and macimorelin testing may fail to diagnose GHD that is caused by hypothalamic defects. 86% agreement 79% agreement 50. Clonidine, L-dopa and arginine are not adequate for testing for GHD in adults. 82% agreement 64% agreement 51. Exercise is not adequate for testing for GHD in adults. 89% agreement 79% agreement 52. A single GH stimulation test is sufficient to diagnose GHD. 71% agreement 50% agreement 53. Insulin tolerance testing is contraindicated in patients with cardiac disease or a history of stroke or seizures. 100% agreement 100% agreement 54. Children with two GH provocative tests with a peak value < 3 µg/l are considered to have complete GHD. 89% agreement 84% agreement 55. Children with two GH provocative tests with peak value < 5 µg/l are considered to have complete GHD. 74% agreement 63% agreement 56. Children with two GH provocative tests with peak value between 5 and 7 µg/l are considered to have partial GHD. 71% agreement 68% agreement 57. Results of GH provocative testing should be adjusted for BMI. 83% agreement 100% agreement 58. For each stimulation test, there is a different cut-off value to determine GHD. 92% agreement 80% agreement 59. In the glucagon stimulation test, there are lower cut-offs to diagnose GHD for patients who have BMI > 30. 79% agreement 67% agreement 60. Some patients with GHD may have a serum IGF-I level in the normal range, although the IGF-I level is usually < 0 SDS for age. 97% agreement 93% agreement 61. In the absence of hypopituitarism, a low IGF-I level is not diagnostic of GHD. 100% agreement 100% agreement.