title: Determining rates of overweight and obese status in children using electronic medical records: Cross-sectional study.
abstract: OBJECTIVE
  To determine the prevalence of overweight and obese status in children by age, sex, and visit type, using data from EMRALD®(Electronic Medical Record Administrative data Linked Database).
  
  
  METHODS
  Heights and weights were abstracted for children 0 to 19 years of age who had at least one well-child visit from January 2010 to December 2011. Using the most recent visit, the proportions and 95% CIs of patients defined as overweight and obese were compared by age group, sex, and visit type using the World Health Organization growth reference standards.
  
  
  METHODS
  Ontario.
  
  
  METHODS
  Children 0 to 19 years of age who were rostered to a primary care physician participating in EMRALD and had at least one well-child visit from January 2010 to December 2011.
  
  
  METHODS
  Proportion and 95% CI of children with overweight and obese status by age group; proportion of children with overweight and obese status by sex (with male sex as the referent) within each age group; and proportion of children with overweight and obese status at the most recent well-child visit type compared with other visit types by age group.
  
  
  RESULTS
  There were 28 083 well-child visits during this period. For children who attended well-child visits, 84.7% of visits had both a height and weight documented. Obesity rates were significantly higher in 1- to 4-year-olds compared with children younger than 1 (6.1% vs 2.3%;P< .001), and in 10- to 14-year-olds compared with 5- to 9-year-olds (12.0% vs 9.0%;P< .05). Both 1- to 4-year-old boys (7.2% vs 4.9%;P< .01) and 10- to 14-year-old boys (14.5% vs 9.6%;P< .05) had higher obesity rates compared with girls. Rates of overweight and obese status were lower using data from well-child visits compared with other visits.
  
  
  CONCLUSIONS
  Electronic medical records might be useful to conduct population-based surveillance of overweight or obese status in children. Methodologic standards, however, should be developed.
authors.affiliation: Associate Professor in the Department of Pediatrics in the Faculty of Medicine at the University of Toronto in Ontario, Scientist in Child Health Evaluative Sciences in the SickKids Research Institute at the Hospital for Sick Children, and Associate Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto. catherine.birken@sickkids.ca.
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Birken
authors.affiliation: Senior Scientist in the Institute for Clinical Evaluative Sciences, Professor in the Department of Family and Community Medicine and the Institute for Health Policy, Management and Evaluation at the University of Toronto, and a family physician in the University Health Network-Toronto Western Hospital Family Health Team.
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.affiliation: Analyst in the Institute for Clinical Evaluative Sciences.
authors.forename: William
authors.initials: W
authors.lastname: Oud
authors.affiliation: Doctoral candidate in the Institute for Health Policy, Management and Evaluation at the University of Toronto and Child Health Evaluative Sciences in the SickKids Research Institute.
authors.forename: Sarah
authors.initials: S
authors.lastname: Carsley
authors.affiliation: Faculty of Medicine at the University of Toronto.
authors.forename: Miranda
authors.initials: M
authors.lastname: Hanna
authors.affiliation: Assistant Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto and Associate Scientist at the Keenan Research Centre in the Li Ka Shing Knowledge Institute at St Michael's Hospital.
authors.forename: Gerald
authors.initials: G
authors.lastname: Lebovic
authors.affiliation: Associate Professor in the Department of Pediatrics in the Faculty of Medicine at the University of Toronto, Senior Associate Scientist in Child Health Evaluative Sciences in the SickKids Research Institute at the Hospital for Sick Children, Associate Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto, and Chief Science Officer at the Institute for Clinical Evaluative Sciences.
authors.forename: Astrid
authors.initials: A
authors.lastname: Guttmann
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017678:Sex Distribution; D055815:Young Adult