Mismatch between the prevalence of overweight and obese children and adolescents and recording in electronic health records: a cross-sectional study.

Abstract

Background: The prevalence of obesity has increased dramatically in recent years. An electronic health record (EHR) can be used to identify and manage overweight and obesity by providing timely information.

Objective: To estimate the prevalence of overweight and obesity using anthropometric data from an EHR and to compare it with the frequency of diagnoses of 'overweight' and 'obesity' registered by pediatricians.

Methods: Cross-sectional, descriptive analytical study from a sample of records from children aged between 2 and 19 years who had at least one well-child visit registered in the EHR over the 24-month period between 2007 and 2008. The record of a diagnosis of overweight or obesity by physicians was compared with estimations based on body mass index (BMI; World Health Organization Growth Reference Data).

Results: Of 14 743 patients aged 2-19 years, 22.1% were overweight and 9.8% were obese. By contrast, a diagnosis of overweight was registered in the EHR for 3.3% of patients, with a figure of 1.1% for obesity. The prevalence of overweight/obesity was lower in adolescents than in children and preschoolers. Based on BMI cut-off points, we found that only 11.5% of the overweight or obese patients had these diagnoses registered in the EHR. Referral to a nutritionist or endocrinolist, and the frequency of selected laboratory tests based on BMI categories vary between 11.8 and 52.5%.

Conclusion: An EHR can contribute to the identification of a population at risk when there is a sub-registry of these diagnoses by primary care physicians.