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Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES): A Comparison of Overweight and Obesity Rates.

ABSTRACT: BACKGROUND:Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples <0.1% of the population and does not target state-level or health system-level measurement. OBJECTIVE:To assess the feasibility of using body mass index (BMI) data from the electronic health record (EHR) to assess rates of overweight and obesity and compare these rates to national NHANES estimates. RESEARCH DESIGN:Using outpatient data from 42 clinics, we studied 388,762 patients in a large health system with at least 1 primary care visit in 2011-2012. MEASURES:We compared crude and adjusted overweight and obesity rates by age category and ethnicity (white, black, Hispanic, Other) between EHR and NHANES participants. Adjusted overweight (BMI?25) and obesity rates were calculated by a 2-step process. Step 1 accounted for missing BMI data using inverse probability weighting, whereas step 2 included a poststratification correction to adjust the EHR population to a nationally representative sample. RESULTS:Adjusted rates of obesity (BMI?30) for EHR patients were 37.3% [95% confidence interval (95% CI), 37.1-37.5] compared with 35.1% (95% CI, 32.3-38.1) for NHANES patients. Among the 16 different obesity class, ethnicity, and sex strata that were compared between EHR and NHANES patients, 14 (87.5%) contained similar obesity estimates (ie, overlapping 95% CIs). CONCLUSIONS:EHRs may be an ideal tool for identifying and targeting patients with obesity for implementation of public health and/or individual level interventions.

SUBMITTER: Funk LM

PROVIDER: S-EPMC6985906 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES): A Comparison of Overweight and Obesity Rates.

Funk Luke M LM Shan Ying Y Voils Corrine I CI Kloke John J Hanrahan Lawrence P LP

Medical care 20170601 6

<h4>Background</h4>Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples <0.1% of the population and does not target state-level or health system-level measurement.<h4>Objective</h4>To assess the feasibility of using body mass index (BMI) data from the electronic health record (EHR) to assess rates of overweigh ...[more]

PMID: 28079710

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Project description:Prevalence and factors associated with obstructive and restrictive lung function in people with chronic kidney disease (CKD) are unknown.Cross-sectional and longitudinal analyses.Participants aged 40 to 79 years from NHANES (National Health and Nutrition Examination Survey) 2007 to 2012 who underwent spirometry testing.CKD (estimated glomerular filtration rate [eGFR] >15-<60mL/min/1.73m(2) or urinary albumin-creatinine ratio ? 30mg/g).Restrictive lung function (defined as FEV1/FVC?0.70 and baseline FVC<80% predicted), obstructive lung function (defined as FEV1/FVC<0.70 based on postbronchodilator spirometric results), and mortality data (available for 2007-2008 and 2009-2010 survey periods).7,610 participants (CKD=1,338; non-CKD=6,272) were included. Prevalences of obstructive lung function adjusted to the mean age of 55 years and 50% men in the CKD and non-CKD groups were 15.6% and 13.3%, respectively (P=0.2). Similarly, adjusted prevalences of restrictive lung function in the CKD and non-CKD groups were 9.8% and 6.7%, respectively (P=0.01). Presence of albumin-creatinine ratio ? 30mg/g was associated with obstructive (OR, 1.42; 95% CI, 1.07-1.88) and restrictive lung function (OR, 1.43; 95% CI, 1.01-2.03) in the entire study cohort. eGFR<60mL/min/1.73m(2) was associated with higher odds of obstructive lung function. In a multivariable Cox model, age (HR, 1.07; 95% CI, 1.04-1.11) and presence of obstructive lung function (HR, 2.68; 95% CI, 1.80-3.97), but not CKD measures, were associated with death.Small proportion of participants with advanced kidney disease.In a representative sample of US adults, impaired lung function is common in those with and without CKD. Albuminuria was independently associated with both obstructive and restrictive lung function, and eGFR<60mL/min/1.73m(2) was associated with higher odds of obstructive lung function. Older age and obstructive lung function were associated with higher likelihood of death. Further studies examining the burden of lung disease in advanced CKD are needed.

Project description:ImportanceHuman papillomavirus (HPV) is a common sexually transmitted infection that is a major cause of noncervical anogenital and oropharyngeal cancers. Prophylactic HPV vaccine is available for primary prevention. However, the population prevalence data for male genital HPV infection is not well known, while the HPV vaccination coverage is low in the United States.ObjectivesTo estimate the prevalence of genital HPV infection and the HPV vaccination rate in the United States among adult men and to examine potential risk factors for HPV infection.Design, setting, and participantsThe National Health and Nutrition Examination Survey (NHANES) samples a representative cross-section of the US population. Men aged 18 to 59 years were examined in mobile examination centers during the NHANES 2013-2014. DNA was extracted from self-collected penile swab specimens, and HPV genotyping was performed by polymerase chain reaction amplification. Demographic and vaccination information was gathered via self-report during home-based standardized interviews. Binary multivariable logistic regression was used to estimate the odds of HPV infection.Main outcomes and measuresThe prevalence of genital HPV infection and the HPV vaccination coverage rate among adult men.ResultsDuring the NHANES 2013-2014, a total of 1868 men aged 18 to 59 years were examined. The overall genital HPV infection prevalence was 45.2% (95% CI, 41.3%-49.3%). The infection prevalence with at least 1 high-risk HPV subtype defined by DNA testing was 25.1% (95% CI, 23.0%-27.3%). In vaccine-eligible men, the prevalence of infection with at least 1 HPV strain targeted by the HPV 4-valent vaccine and HPV 9-valent vaccine was 7.1% (95% CI, 5.1%-9.5%) and 15.4% (95% CI, 11.7%-19.6%), respectively. Among vaccine-eligible men, the HPV vaccination coverage was 10.7% (95% CI, 7.8%-14.6%).Conclusions and relevanceAmong men aged 18 to 59 years in the United States, the overall prevalence of genital HPV infection was 45.2% (95% CI, 41.3%-49.3%). The overall genital HPV infection prevalence appears to be widespread among all age groups of men, and the HPV vaccination coverage is low.

Dataset Information

Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES): A Comparison of Overweight and Obesity Rates.

Publications

Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES): A Comparison of Overweight and Obesity Rates.

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