title: 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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Section on Clinical Pediatrics, Hospital Italiano de Buenos Aires, Argentina. paula.otero@hospitalitaliano.org.ar
authors.forename: Paula
authors.initials: P
authors.lastname: Otero
authors.forename: Pablo
authors.initials: P
authors.lastname: Durán
authors.forename: Débora
authors.initials: D
authors.lastname: Setton
authors.forename: Alfredo
authors.initials: A
authors.lastname: Eymann
authors.forename: Julio
authors.initials: J
authors.lastname: Busaniche
authors.forename: Julián
authors.initials: J
authors.lastname: Llera
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care; D058996:Quality Improvement; D055815:Young Adult