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

Children (Basel). 2020 Jun 27;7(7):67. doi: 10.3390/children7070067.

Abstract

Background: Childhood obesity is associated with dyslipidemia, fatty liver disease, and type 2 diabetes. Expert guidelines recommend screening for these conditions in children with obesity.

Aims and objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: comorbidity; diabetes mellitus; dyslipidemia; liver diseases; pediatric obesity; point-of-care systems; type 2.