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Since the introduction of new growth charts in the mid 1990s, there has been confusion about which charts should be used, with many districts using more than one version. Because of this uncertainty, an expert working party, the Growth Reference Review Group, was convened by the Royal College of Paediatrics and Child Health to provide guidance on the validity and comparability of the different charts currently in use. This paper describes the technical background to the construction and evaluation of growth charts and outlines the group's findings on the validity of each growth reference in relation to contemporary British children. The group concluded that for most clinical purposes the UK90 reference is superior and for many measures is the only usable reference that can be recommended, while the original Tanner-Whitehouse and the Gairdner-Pearson charts are no longer reliable for use at any age. After the age of 2 the revised Buckler-Tanner references are still suitable for assessing height. There are presently no reliable head circumference reference charts for use beyond infancy. The group propose that apart from refinements of chart design and layout, the new UK90 reference should now be "frozen", with any future revisions only undertaken after careful planning and widespread consultation.

If a court fails to convict a defendant because of incomplete evidence, does that establish his innocence beyond doubt? Not necessarily. Indeed in Scotland, if sufficient uncertainty remains, the court can give a verdict of “not proven” instead of “not guilty”. If a randomised controlled trial (RCT) fails to show a significant difference between the treatment and the control group, does that prove that the treatment has no useful clinical effect? Again, not necessarily. The treatment may work, but the trial may have been unable to prove it.1 Despite this, many such “negative” trials,1 2 including many published in this journal, may wrongly be taken as evidence that the treatment is not clinically useful. For example, in an RCT of women at risk of preterm delivery that was not published as a full report,3 respiratory distress syndrome (RDS) occurred in three of 23 babies born to the treated group and three of 22 babies born to the untreated group. The difference is not significant (2p > 0.9). Had this been the first and only study of this treatment, many people might have decided that it was not effective and thus lost interest. In fact, overviews of this,3 and at least 14 other trials, eventually showed that the treatment—antenatal steroids—is highly effective because it reduced RDS and neonatal mortality in over 3500 preterm infants by about half.4 5 Note that the results of the single trial were quite consistent with this finding.3 The correct conclusion from that single trial …

Editor—Dr Marlow’s interesting annotation on high frequency ventilation,1 with its pithy epigraph, adopts a common attitude to the methodology of medical research. This holds that, to be “scientific,” a study must specify a null hypothesis and then attempt, using data, to disprove it. This agrees with the writings of Karl Popper, but goes back further to the founding father of modern statistics, R A Fisher, who2 wrote: “Every experiment may …