OBJECTIVE: To evaluate general practitioners' (GPs') assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI) according to paediatric standard definitions. DESIGN: A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. SETTING: The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region. SUBJECTS: Children attending the five-year PCHE in general practice, regardless of their weight status. MAIN OUTCOME MEASURES: Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed with regard to sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GPs' assessment of weight-for-stature. RESULTS: A total of 165 GPs conducted 1138 PCHEs. GPs assessed that 171 children had a weight-for-stature above normal. Use of the Danish Standards (DS), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0-77.3) and a specificity of 92.4% (95% CI 90.6-93.9). The sensitivity was influenced by the GPs' use of BMI and the presence of previous notes regarding abnormal weight development. CONCLUSION: At the five-year PCHE almost one-third of overweight children were assessed to be normal weight by GPs. Use of BMI and presence of notes on abnormal weight in medical records were positively associated with a higher identification. Hence, utilization of medical record data and BMI charts may refine GPs' assessment of childhood overweight.
OBJECTIVE: To evaluate general practitioners' (GPs') assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI) according to paediatric standard definitions. DESIGN: A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. SETTING: The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region. SUBJECTS:Children attending the five-year PCHE in general practice, regardless of their weight status. MAIN OUTCOME MEASURES: Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed with regard to sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GPs' assessment of weight-for-stature. RESULTS: A total of 165 GPs conducted 1138 PCHEs. GPs assessed that 171 children had a weight-for-stature above normal. Use of the Danish Standards (DS), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0-77.3) and a specificity of 92.4% (95% CI 90.6-93.9). The sensitivity was influenced by the GPs' use of BMI and the presence of previous notes regarding abnormal weight development. CONCLUSION: At the five-year PCHE almost one-third of overweight children were assessed to be normal weight by GPs. Use of BMI and presence of notes on abnormal weight in medical records were positively associated with a higher identification. Hence, utilization of medical record data and BMI charts may refine GPs' assessment of childhood overweight.
Authors: Grethe Søndergaard; Sofie Biering-Sørensen; Susan Ishøy Michelsen; Ole Schnor; Anne-Marie Nybo Andersen Journal: Scand J Prim Health Care Date: 2008 Impact factor: 2.581
Authors: David S Freedman; Henry S Kahn; Zuguo Mei; Laurence M Grummer-Strawn; William H Dietz; Sathanur R Srinivasan; Gerald S Berenson Journal: Am J Clin Nutr Date: 2007-07 Impact factor: 7.045
Authors: Henry S Kahn; Laure El ghormli; Russell Jago; Gary D Foster; Robert G McMurray; John B Buse; Diane D Stadler; Roberto P Treviño; Tom Baranowski Journal: J Obes Date: 2014-07-14