Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity

• Published in: Children (Basel) 2020-06, Vol.7 (7), p.67
• Main Authors: Kaufman, Tara K, Gentile, Natalie, Kumar, Seema, Halle, Marian, Lynch, Brian A, Cristiani, Valeria, Fischer, Karen, Chaudhry, Rajeev
• Format: Article
• Language: English
• Subjects: Childhood obesity; Decision support systems; diabetes mellitus; Diagnosis; dyslipidemia; liver diseases; pediatric obesity; point-of-care systems; type 2
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children7070067

Childhood obesity is associated with dyslipidemia, fatty liver disease, and type 2 diabetes. Expert guidelines recommend screening for these conditions in children with obesity. The objective of the study was to compare rates of laboratory screening for dyslipidemia, fatty liver disease, and type 2 diabetes in children with obesity prior to and following implementation of a point-of-care decision support tool. We performed a retrospective record review of children with body mass index (BMI) ≥95th percentile for age and gender (age 7-18 years) undergoing well-child/sports examination visits. Multivariable logistic regression models were used to adjust for patient and provider confounders. There was no increase in the rates of screening following implementation of the point-of-care decision support tool. Tests were more likely to be recommended in children with severe obesity and in females. The implementation of a point-of-care decision support tool was not associated with improvement in screening rates for dyslipidemia, fatty liver disease, and type 2 diabetes for children with obesity. Further strategies are needed to improve rates of screening for obesity-related comorbid conditions in children with obesity.