Low levels of knowledge on the assessment of underweight in children and adolescents among middle-grade doctors in England and Wales.
BACKGROUND
Safe assessment of severe underweight in children is important but experience suggests a frequent lack of understanding. Here we sought evidence from a wide spectrum of trainees.


METHODS
Cross-sectional telephone survey of an on-call middle-grade paediatric doctor in hospitals providing acute inpatient general paediatric care in England and Wales.


RESULTS
Response rate was 100%. Only 50% identified BMI as the appropriate measure for underweight in children. Most did not identify any clinical cardiovascular complications of severe underweight. Only 13% identified corrected QT time (QTc) as an important ECG finding. Knowledge of the refeeding syndrome was poor with 20% unable to define it at all, 21% able to identify some clinical features and 57% aware of potential phosphate abnormalities.


CONCLUSIONS
Knowledge base among middle-grades doctors in England and Wales on this topic is worryingly poor, particularly in relation to several life-threatening features. Existing and new training approaches should recognise this.
General and Adolescent Paediatric Unit, UCL Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK. l.hudson@ucl.ac.uk
Lee D
LD
Hudson
Charlotte
C
Cumby
Robert E
RE
Klaber
Dasha E
DE
Nicholls
Paul J
PJ
Winyard
Russell M
RM
Viner
D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology; D002648:Child; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D004562:Electrocardiography; D004739:England; D006801:Humans; D010372:Pediatrics / Q000193:education*; D055677:Refeeding Syndrome / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013851:Thinness / Q000150:complications / Q000175:diagnosis*; D014852:Wales