How accurate is Tanner's formula in estimating target height?

Growth evaluation is one of the most common reasons for referral to pediatric endocrinologists. While many factors, including nutritional status, comorbidities, and hormonal imbalances, can affect growth, a child's adult height (AH) is primarily influenced by parental stature. Target height (TH) calculation is a widely used tool to assess whether a child is growing within the expected familial range. Despite its popularity, Tanner's formula, proposed in 1970, has faced criticism, and alternative formulas have been suggested. Several factors, such as sex differences in stature, secular trends, height disparity between parents, assortative mating, and parent-child height correlations, may affect the accuracy of TH calculation. Additionally, the formula tends to underestimate AH in children from very short parents, leading to underestimation of growth potential and overestimation of the effect of growth-promoting therapies.