Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity
Abstract
:1. Introduction
2. Methods
3. Statistical Methods
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Total (N = 1087) | 2009 (N = 342) | 2011 (N = 366) | 2013 (N = 379) | |
---|---|---|---|---|
Gender | ||||
Male | 660 (60.7%) | 202 (59.1%) | 231 (63.1%) | 227 (59.9%) |
Female | 427 (39.3%) | 140 (40.9%) | 135 (36.9%) | 152 (40.1%) |
Race | ||||
Black | 77 (7.1%) | 18 (5.3%) | 23 (6.3%) | 36 (9.5%) |
White | 850 (78.2%) | 271 (79.2%) | 288 (78.7%) | 291 (76.8%) |
Unknown | 160 (14.7%) | 53 (15.5%) | 55 (15.0%) | 52 (13.7%) |
Specialty | ||||
Family Medicine | 559 (51.4%) | 171 (50.0%) | 198 (54.1%) | 190 (50.1%) |
Pediatrics | 528 (48.6%) | 171 (50.0%) | 168 (45.9%) | 189 (49.9%) |
Age group | ||||
7–10 years | 89 (8.2%) | 28 (8.2%) | 29 (7.9%) | 32 (8.4%) |
11–14 years | 658 (60.5%) | 202 (59.1%) | 218 (59.6%) | 238 (62.8%) |
15–18 years | 340 (31.3%) | 112 (32.8%) | 119 (32.5%) | 109 (28.8%) |
Insurance | ||||
Commercial | 877 (80.7%) | 285 (83.3%) | 293 (80.1%) | 299 (78.9%) |
Medicaid | 176 (16.2%) | 49 (14.3%) | 60 (16.4%) | 67 (17.7%) |
Other | 34 (3.1%) | 8 (2.3%) | 13 (3.6%) | 13 (3.4%) |
Provider Type *† | ||||
Nurse Practitioner | 251 (23.2%) | 54 (15.8%) | 112 (30.8%) | 85 (22.6%) |
Resident | 224 (20.7%) | 74 (21.7%) | 73 (20.1%) | 77 (20.5%) |
Staff | 606 (56.1%) | 213 (62.5%) | 179 (49.2%) | 214 (56.9%) |
Obesity Status | ||||
Non Severe | 926 (85.2%) | 297 (86.8%) | 316 (86.3%) | 313 (82.6%) |
Severe | 161 (14.8%) | 45 (13.2%) | 50 (13.7%) | 66 (17.4%) |
Univariate Analysis | Multiple Regression Analysis | |||
---|---|---|---|---|
Odds Ratio (95% CI) | p-Value * | Odds Ratio (95% CI) | p-Value * | |
Year | ||||
2009 | ref | ref | ||
2011 | 1.09 (0.73, 1.64) | 0.675 | 1.17 (0.75, 1.83) | 0.487 |
2013 | 0.82 (0.53, 1.26) | 0.362 | 0.83 (0.52, 1.33) | 0.438 |
Gender | ||||
Male | ref | ref | ||
Female | 1.91 (1.35, 2.70) | 0.0002 | 1.95 (1.33, 2.87) | 0.001 |
Race | ||||
White | ref | ref | ||
Black | 1.05 (0.54, 2.04) | 0.890 | 0.58 (0.25, 1.32) | 0.192 |
Unknown | 1.17 (0.73, 1.87) | 0.518 | 1.11 (0.66, 1.87) | 0.700 |
Specialty | ||||
Family Medicine | ref | ref | ||
Pediatrics | 4.14 (2.79, 6.14) | <0.001 | 5.14 (3.34, 7.92) | <0.001 |
Age Group | ||||
7–10 | 0.32 (0.12, 0.90) | 0.031 | 0.21 (0.07, 0.63) | 0.005 |
11–14 | ref | ref | ||
15–18 | 1.61 (1.14, 2.30) | 0.008 | 1.93 (1.32, 2.84) | 0.001 |
Insurance | ||||
Commercial | ref | ref | ||
Medicaid | 1.33 (0.87, 2.05) | 0.192 | 1.16 (0.68, 1.99) | 0.588 |
Other | 0.17 (0.02, 1.23) | 0.080 | 0.18 (0.03, 1.29) | 0.088 |
Provider Type | ||||
Staff | ref | ref | ||
NP | 1.46 (0.97, 2.19) | 0.071 | 1.32 (0.83, 2.10) | 0.234 |
Resident | 1.32 (0.85, 2.03) | 0.213 | 1.11 (0.69, 1.78) | 0.671 |
Obesity Status | ||||
Moderate | ref | ref | ||
Severe | 2.18 (1.45, 3.29) | 0.0002 | 2.54 (1.61, 4.01) | <0.001 |
Total (N = 1087) | 2009 (N =342) | 2011 (N = 366) | 2013 (N = 379) | p-Value * | |
---|---|---|---|---|---|
Glucose | |||||
Yes | 135 (12.4%) | 43 (12.6%) | 53 (14.5%) | 39 (10.3%) | 0.338 |
No | 952 (87.6%) | 299 (87.4%) | 313 (85.5%) | 340 (89.7%) | |
A1C | |||||
Yes | 17 (1.6%) | 6 (1.8%) | 4 (1.1%) | 7 (1.9%) | 1.00 |
No | 1070 (98.4%) | 336 (98.3%) | 362 (98.9%) | 372 (98.2%) | |
ALT | |||||
Yes | 110 (10.1%) | 35 (10.2%) | 51 (13.9%) | 24 (6.3%) | 0.073 |
No | 977 (89.9%) | 307 (89.8%) | 315 (86.1%) | 355 (93.7%) | |
Triglycerides | |||||
Yes | 131 (12.1%) | 44 (12.9%) | 49 (13.4%) | 38 (10.0%) | 0.253 |
No | 956 (88.0%) | 298 (87.1%) | 317 (86.6%) | 341 (90.1%) | |
HDL | |||||
Yes | 129 (11.9%) | 44 (12.9%) | 48 (13.1%) | 37 (9.8%) | 0.205 |
No | 958 (88.1%) | 298 (87.1%) | 318 (86.9%) | 342 (90.2%) | |
LDL | |||||
Yes | 129 (11.9%) | 44 (12.9%) | 48 (13.1%) | 37 (9.8%) | 0.205 |
No | 958 (88.1%) | 298 (87.1%) | 318 (86.9%) | 342 (90.2%) | |
Any Testing Performed | |||||
Yes | 153 (14.1%) | 50 (14.6%) | 57 (15.6%) | 46 (12.1%) | 0.335 |
No | 934 (85.9%) | 292 (85.4%) | 309 (84.4%) | 333 (87.9%) |
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Kaufman, T.K.; Gentile, N.; Kumar, S.; Halle, M.; Lynch, B.A.; Cristiani, V.; Fischer, K.; Chaudhry, R. Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity. Children 2020, 7, 67. https://doi.org/10.3390/children7070067
Kaufman TK, Gentile N, Kumar S, Halle M, Lynch BA, Cristiani V, Fischer K, Chaudhry R. Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity. Children. 2020; 7(7):67. https://doi.org/10.3390/children7070067
Chicago/Turabian StyleKaufman, Tara K., Natalie Gentile, Seema Kumar, Marian Halle, Brian A. Lynch, Valeria Cristiani, Karen Fischer, and Rajeev Chaudhry. 2020. "Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity" Children 7, no. 7: 67. https://doi.org/10.3390/children7070067
APA StyleKaufman, T. K., Gentile, N., Kumar, S., Halle, M., Lynch, B. A., Cristiani, V., Fischer, K., & Chaudhry, R. (2020). Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity. Children, 7(7), 67. https://doi.org/10.3390/children7070067