Sensitivity of Clinical Pediatric Obesity Diagnosis Documented in Electronic Health Records

Objective. This study tested the sensitivity of obesity diagnosis in electronic health records (EHRs) using body mass index (BMI) classification and identified variables associated with obesity diagnosis. Methods. Eligible children aged 2 to 18 years had a calculable BMI in 2017 and had at least 1 visit in 2016 and 2017. Sensitivity of clinical obesity diagnosis compared with children’s BMI percentile was calculated. Logistic regression was performed to determine variables associated with obesity diagnosis. Results. Analyses included 31 059 children with BMI at or above 95th percentile. Sensitivity of clinical obesity diagnosis was 35.81%. Clinical obesity diagnosis was more likely if the child had a well visit, had Medicaid insurance, was female, Hispanic or Black, had a chronic disease diagnosis, and saw a provider in a practice in an urban area or with academic affiliation. Conclusion. Sensitivity of clinical obesity diagnosis in EHR is low. Clinical obesity diagnosis is associated with nonmodifiable child-specific factors but also modifiable practice-specific factors.