| Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians. | |
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MedLine Citation:
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PMID: 12093999 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The primary aim of this study was to determine how pediatric health care providers identify overweight in children and adolescents and how they evaluate obesity-related medical complications. This information can guide development of programs to help providers improve their evaluation practices. A secondary objective was to examine the association of certain provider characteristics with recommended evaluation practices. METHODS: A random sample of pediatricians, pediatric nurse practitioners (PNPs), and registered dietitians received a questionnaire about their evaluation of overweight children and adolescents. Results were compared with published recommendations. Associations between respondent characteristics and adherence to published recommendations were examined. RESULTS: A total 940 providers responded (response rate: 19%-33%). Among all 3 groups a majority frequently used clinical impression, weight-for-age percentile, weight-for-height percent, and weight-for-height percentile to assess degree of overweight. Nearly all pediatricians and PNPs routinely evaluated blood pressure, but a minority routinely looked for orthopedic problems, insulin resistance, and sleep disorders. Less than 10% followed all recommendations for history and physical examination. Two thirds of pediatricians and PNPs routinely tested for lipid abnormalities. Most providers asked about family history of overweight, hypertension, cardiovascular disease, and diabetes, but only one third asked about gallbladder disease. In general, the provider's specialty, years in practice, gender, and body mass index were not associated with adherence to recommended practices. CONCLUSIONS: Medical evaluation of overweight children and adolescents fell short of recommended practices. These results point to the need for educational efforts to increase awareness of medical risks and for tools to facilitate more complete evaluation during office visits. |
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Authors:
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Sarah E Barlow; William H Dietz; William J Klish; Frederick L Trowbridge |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Pediatrics Volume: 110 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-02 Completed Date: 2002-07-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 222-8 Citation Subset: AIM; IM |
Affiliation:
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St Louis University School of Medicine, St Louis, Missouri 63104, USA. barlowse@slu.edu . |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Body Mass Index Child Diabetes Mellitus, Type 2 / diagnosis Diagnosis, Differential Dietetics / statistics & numerical data* Female Humans Male Medical History Taking / methods Nurse Practitioners / statistics & numerical data Obesity / diagnosis* Pediatric Nursing / statistics & numerical data* Pediatrics / statistics & numerical data* Physical Examination / methods Physician's Practice Patterns / statistics & numerical data* Questionnaires Random Allocation Skinfold Thickness Thyroid Function Tests / statistics & numerical data United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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