Sensitivity of Clinical Pediatric Obesity Diagnosis Documented in Electronic Health Records

Area of Science:

• Pediatric Health
• Public Health
• Health Informatics

Background:

• Childhood obesity is a significant public health concern.
• Accurate diagnosis in electronic health records (EHRs) is crucial for effective management.
• Current methods for obesity diagnosis in EHRs may lack sufficient sensitivity.

Purpose of the Study:

• To evaluate the sensitivity of obesity diagnosis using body mass index (BMI) classification in EHRs.
• To identify factors associated with the accurate clinical diagnosis of obesity in children.
• To assess the performance of EHR-based obesity diagnosis compared to BMI percentiles.

Main Methods:

• Analysis of EHR data for children aged 2-18 years with calculable BMI in 2017.
• Calculation of sensitivity for clinical obesity diagnosis against children's BMI percentile.
• Logistic regression modeling to identify variables associated with obesity diagnosis.

Main Results:

• The study included 31,059 children with BMI at or above the 95th percentile.
• Sensitivity of clinical obesity diagnosis in EHRs was found to be 35.81%.
• Obesity diagnosis was more likely in children with well visits, Medicaid, specific demographics (female, Hispanic, Black), chronic conditions, and those seen in urban or academic practices.

Conclusions:

• The sensitivity of clinical obesity diagnosis within EHR systems is notably low.
• Diagnosis is influenced by nonmodifiable child-specific factors and modifiable practice-specific factors.
• Improvements in EHR data capture and clinical practice are needed for better childhood obesity identification.