Overweight and obese children are frequently not receiving recommended screening tests for obesity-related conditions, according to a study published in the April 11 issue of Morbidity and Mortality Weekly Report. A lack of awareness of testing-related guidelines may contribute to the low rates of utilization of these screening tests. In response to the rise in obesity among U.S. children and adolescents from 1980 to 2010, the American Academy of Pediatrics recommended targeted laboratory screening for metabolic disorders, including lipid panel testing, among children and adolescents with a body mass index (BMI) at or above the 85th percentile based on age or presence of certain risk factors, beginning at age 10 years. The researchers utilized data from a population of children and teens enrolled in Maryland Medicaid or the Maryland Children’s Health Program to determine whether or not screenings, per the recommendations, were being performed in routine clinical practice. BMI percentiles were calculated for a random sample of 1,600 children (aged 2 years to 19 years) per year (2005 to 2010) who were seen for a well-child visit. Laboratory tests undertaken and diagnosed obesity-related conditions were identified through medical encounter records. The researchers found that 16.5 percent of the included children […]
Overweight and obese children are frequently not receiving recommended screening tests for obesity-related conditions, according to a study published in the April 11 issue of Morbidity and Mortality Weekly Report. A lack of awareness of testing-related guidelines may contribute to the low rates of utilization of these screening tests.
In response to the rise in obesity among U.S. children and adolescents from 1980 to 2010, the American Academy of Pediatrics recommended targeted laboratory screening for metabolic disorders, including lipid panel testing, among children and adolescents with a body mass index (BMI) at or above the 85th percentile based on age or presence of certain risk factors, beginning at age 10 years.
The researchers utilized data from a population of children and teens enrolled in Maryland Medicaid or the Maryland Children’s Health Program to determine whether or not screenings, per the recommendations, were being performed in routine clinical practice. BMI percentiles were calculated for a random sample of 1,600 children (aged 2 years to 19 years) per year (2005 to 2010) who were seen for a well-child visit. Laboratory tests undertaken and diagnosed obesity-related conditions were identified through medical encounter records.
The researchers found that 16.5 percent of the included children were overweight (BMI from 85th to 94th percentiles) and 21.4 percent were obese (BMI of 95th percentile or above), with no significant change in the prevalence of overweight and obesity during the study period. There was a significant increase in the diagnosis of obesity-related conditions with increasing BMI, with 33.5 percent of obese participants diagnosed with asthma, 7.9 percent diagnosed with dyslipidemia, and 7.2 percent diagnosed with depression. Lipid panel tests were undertaken in only 29.9 percent of overweight and 40.2 percent of obese participants.
Co-author Cheryl De Pinto, M.D., from the Maryland Department of Health and Mental Hygiene, tells DTET that while noncompliance in executing lab orders may contribute to the low rates of testing, a lack of provider education about the need to test in this population may also be a contributor.
Takeaway: At-risk kids and teens are not being adequately tested for obesity-related conditions. While patient noncompliance may in part contribute to low testing rates, laboratories can work with pediatricians and other providers to ensure knowledge of obesity-related testing guidelines.
