Perrin Eliana Miller, Flower Kori B, Ammerman Alice S
Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, CB #7220, 200 Mason Farm Road, 5th Floor, Chapel Hill, NC 27599-7220, USA.
J Pediatr. 2004 Apr;144(4):455-60. doi: 10.1016/j.jpeds.2004.01.047.
To determine how frequently pediatricians use body mass index (BMI) and whether pediatricians are more likely to regard a child as "too fat" and manifest greater concern about health sequelae when presented with BMI versus height and weight charting.
North Carolina Pediatrics Society members completed a self-administered, quasi-experimental mail survey, using two different case vignette versions. They were given a clinical vignette but systematically received either the same hypothetical overweight child's height and weight data, percentile, and charts (Ht and Wt Group) or her BMI, percentile, and chart (BMI Group). They rated levels of fatness and concern by using Likert scales and the frequency of use of methods to determine overweight.
Adjusted response rate was 71% (N = 356). The BMI Group rated the hypothetical child with a higher mean on a scale of fatness (P < .0001) and reported higher levels of concern about all consequences (all P values < or = .01) than those in the Ht and Wt Group. Only 11% of respondents reported "always," and 31% reported "never," using BMI.
BMI charting prompted greater recognition of a weight problem than height and weight charting, yet BMI is inconsistently used. Interventions to help pediatricians adopt this tool may be warranted.
确定儿科医生使用体重指数（BMI）的频率，以及当呈现BMI与身高和体重图表时，儿科医生是否更有可能将儿童视为“过于肥胖”并对健康后遗症表现出更大的担忧。
北卡罗来纳州儿科学会成员使用两种不同的病例 vignette 版本完成了一项自我管理的准实验性邮件调查。他们收到一个临床 vignette，但系统地收到同一个假设超重儿童的身高和体重数据、百分位数及图表（身高和体重组）或其BMI、百分位数及图表（BMI组）。他们使用李克特量表对肥胖程度和担忧程度进行评分，并确定用于判断超重的方法的使用频率。
调整后的回复率为71%（N = 356）。与身高和体重组相比，BMI组对假设儿童的肥胖程度评分更高（P <.0001），并且对所有后果的担忧程度更高（所有P值<或 = .01）。只有11%的受访者报告“总是”使用BMI，31%的受访者报告“从不”使用BMI。
与身高和体重图表相比，BMI图表能促使人们更清楚地认识到体重问题，但BMI的使用并不一致。可能有必要采取干预措施来帮助儿科医生采用这一工具。
