Diagnosis and Screening of Overweight and Obese Children in a Resident Continuity Clinic

Area of Science:

• Pediatric Health
• Clinical Informatics
• Public Health

Background:

• Childhood obesity is a growing public health concern.
• Early identification and intervention are vital for managing pediatric excess weight.
• Electronic medical records (EMR) offer a platform for documenting patient conditions.

Purpose of the Study:

• To assess the relationship between excess weight documentation in EMR and the subsequent ordering of screening tests for pediatric patients.
• To identify factors influencing the documentation of excess weight in a pediatric resident clinic.

Main Methods:

• Retrospective review of well-child visits for patients aged 2-18 years.
• Analysis of patients with body mass index (BMI) at or above the 85th percentile.
• Evaluation of EMR documentation of excess weight and ordered screening tests.
• Statistical analysis using chi-squared (χ2) tests.

Main Results:

• 41% of 522 pediatric patients were overweight (19%) or obese (22%).
• Only 43% of overweight/obese patients had excess weight documented in their EMR.
• Screening tests were ordered for 42% of patients with documented excess weight versus 6.5% without (P < .001).

Conclusions:

• Documentation rates of excess weight in pediatric EMRs are suboptimal.
• Documentation was lower for younger children and those with less severe excess weight.
• Documenting excess weight in the EMR strongly correlates with ordering appropriate screening tests.