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Iris R. Mabry, MD, MPH, Sarah J. Clark, MPH, and Michael D. Cabana, MD, MPH. Division of General Pediatrics, University of Michigan, 300 North Ingalls Building, Ann Arbor, MI 48109, 734-615-8214, imabry@ahrq.gov
An expert pediatric panel developed recommendations for the care of obese children, including calculating Body Mass Index (BMI), ordering lab tests when indicated, and getting a complete diet history, physical activity and sedentary histories, and a family medical history of diseases, such as type 2 diabetes or cardiovascular disease. To explore pediatricians’ actions during outpatient visits for which the diagnostic code for obesity is applied to a child for the first time (“initial obesity visit”), we conducted a chart review of a university-affiliated network of pediatric clinics, focusing on children with an initial obesity visit between January 1997 and December 2002. We abstracted documentation regarding patient demographics, physical examination, history, and lab tests ordered. Medical records for 171 of 198 (86%) eligible patients were available for analysis. BMI was rarely documented (5%) in patients. Sedentary history was documented in 14% of patients; family medical history was documented in 30% of patients; physical activity history was documented in 41% of patients; and diet history was documented in 60% of patients. Documentation of lab testing occurred in 47% of patients. Further research is needed to understand current pediatric practice and how pediatricians may improve their clinical evaluation of childhood obesity.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.