Birken Catherine S, Tu Karen, Oud William, Carsley Sarah, Hanna Miranda, Lebovic Gerald, Guttmann Astrid
Associate Professor in the Department of Pediatrics in the Faculty of Medicine at the University of Toronto in Ontario, Scientist in Child Health Evaluative Sciences in the SickKids Research Institute at the Hospital for Sick Children, and Associate Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto.
Senior Scientist in the Institute for Clinical Evaluative Sciences, Professor in the Department of Family and Community Medicine and the Institute for Health Policy, Management and Evaluation at the University of Toronto, and a family physician in the University Health Network-Toronto Western Hospital Family Health Team.
Can Fam Physician. 2017 Feb;63(2):e114-e122.
To determine the prevalence of overweight and obese status in children by age, sex, and visit type, using data from EMRALD (Electronic Medical Record Administrative data Linked Database).
Heights and weights were abstracted for children 0 to 19 years of age who had at least one well-child visit from January 2010 to December 2011. Using the most recent visit, the proportions and 95% CIs of patients defined as overweight and obese were compared by age group, sex, and visit type using the World Health Organization growth reference standards.
Ontario.
Children 0 to 19 years of age who were rostered to a primary care physician participating in EMRALD and had at least one well-child visit from January 2010 to December 2011.
Proportion and 95% CI of children with overweight and obese status by age group; proportion of children with overweight and obese status by sex (with male sex as the referent) within each age group; and proportion of children with overweight and obese status at the most recent well-child visit type compared with other visit types by age group.
There were 28 083 well-child visits during this period. For children who attended well-child visits, 84.7% of visits had both a height and weight documented. Obesity rates were significantly higher in 1- to 4-year-olds compared with children younger than 1 (6.1% vs 2.3%; < .001), and in 10- to 14-year-olds compared with 5- to 9-year-olds (12.0% vs 9.0%; < .05). Both 1- to 4-year-old boys (7.2% vs 4.9%; < .01) and 10- to 14-year-old boys (14.5% vs 9.6%; < .05) had higher obesity rates compared with girls. Rates of overweight and obese status were lower using data from well-child visits compared with other visits.
Electronic medical records might be useful to conduct population-based surveillance of overweight or obese status in children. Methodologic standards, however, should be developed.
利用EMRALD（电子病历管理数据链接数据库）的数据，按年龄、性别和就诊类型确定儿童超重和肥胖状况的患病率。
提取2010年1月至2011年12月期间至少有一次健康儿童就诊记录的0至19岁儿童的身高和体重数据。根据世界卫生组织生长参考标准，按年龄组、性别和就诊类型比较最近一次就诊时超重和肥胖患者的比例及95%置信区间。
安大略省。
登记在参与EMRALD的初级保健医生名下、2010年1月至2011年12月期间至少有一次健康儿童就诊记录的0至19岁儿童。
按年龄组划分的超重和肥胖儿童的比例及95%置信区间；各年龄组内按性别（以男性为参照）划分的超重和肥胖儿童的比例；按年龄组划分的最近一次健康儿童就诊类型与其他就诊类型相比超重和肥胖儿童的比例。
在此期间共有28083次健康儿童就诊。在进行健康儿童就诊的儿童中，84.7%的就诊记录了身高和体重。1至4岁儿童的肥胖率显著高于1岁以下儿童（6.1%对2.3%；P<0.001），10至14岁儿童的肥胖率显著高于5至9岁儿童（12.0%对9.0%；P<0.05）。1至4岁男孩（7.2%对4.9%；P<0.01）和10至14岁男孩（14.5%对9.6%；P<0.05）的肥胖率均高于女孩。与其他就诊相比，健康儿童就诊数据得出的超重和肥胖状况发生率较低。
电子病历可能有助于对儿童超重或肥胖状况进行基于人群的监测。然而，应制定方法学标准。
