Diagnosis and Screening of Overweight and Obese Children in a Resident Continuity Clinic

Objective. To evaluate the association between documenting excess weight and ordering screening tests. Methods. We retrospectively reviewed well-child visits for patients 2 to 18 years old at a pediatric resident clinic. We evaluated visits of patients with body mass index ≥ 85th percentile for documentation of excess weight in the electronic medical record (EMR) and screening tests ordered. Associations were investigated with χ(2) tests. Results. Of 522 patients, 215 (41%) were overweight (19%) or obese (22%). Among obese and overweight patients, 92/215 (43%) had documentation of excess weight in the EMR. Screening tests were ordered for 39/92 (42%) patients with a diagnosis of excess weight versus 8/123 (6.5%) of those without one (P < .001). Conclusions. Documentation rates of excess weight by practitioners were low and worse for younger children and those with milder degrees of excess weight. Documenting excess weight in the EMR was highly associated with ordering of screening tests.