title: Evaluation of general practitioners' assessment of overweight among children attending the five-year preventive child health examination: a cross-sectional survey.
abstract: 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.
  
  
  METHODS
  A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular.
  
  
  METHODS
  The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region.
  
  
  METHODS
  Children attending the five-year PCHE in general practice, regardless of their weight status.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Section for General Practice and Research Unit for General Practice, Department of Public Health, Aarhus University, Denmark. mka@alm.au.dk
authors.forename: Merethe Kousgaard
authors.initials: MK
authors.lastname: Andersen
authors.forename: Bo
authors.initials: B
authors.lastname: Christensen
authors.forename: Carsten
authors.initials: C
authors.lastname: Obel
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003718:Denmark; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000175:diagnosis*; D011314:Preventive Health Services / Q000592:standards*; D012015:Reference Standards; D011795:Surveys and Questionnaires