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Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales

Lucy Griffiths Orcid Logo, Jim Rafferty Orcid Logo, Rich Fry Orcid Logo, Helen Daniels Orcid Logo, Carol Dezateux Orcid Logo, Nicola Firman, Theodora Pouliou, Gareth Stratton Orcid Logo, Amy Mizen Orcid Logo, Ronan Lyons Orcid Logo, Alan Watkins Orcid Logo, Jo Davis, Rowena Bailey

PLOS ONE, Volume: 19, Issue: 5, Start page: e0300221

Swansea University Authors: Lucy Griffiths Orcid Logo, Jim Rafferty Orcid Logo, Rich Fry Orcid Logo, Helen Daniels Orcid Logo, Gareth Stratton Orcid Logo, Amy Mizen Orcid Logo, Ronan Lyons Orcid Logo, Alan Watkins Orcid Logo, Jo Davis, Rowena Bailey

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DOI (Published version): 10.1371/journal.pone.0300221

Abstract

Background: Routine monitoring of Body Mass Index (BMI) in general practice, and via national surveillance programmes, is essential for the identification, prevention, and management of unhealthy childhood weight. We examined and compared the presence and representativeness of children and young peo...

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ISSN: 1932-6203
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We examined and compared the presence and representativeness of children and young people's (CYPs) BMI recorded in two routinely collected administrative datasets: general practice electronic health records (GP-BMI) and the Child Measurement Programme for Wales (CMP-BMI), which measures height and weight in 4-5-year-old school children. We also assessed the feasibility of combining GP-BMI and CMP-BMI data for longitudinal analyses.Methods: We accessed de-identified population-level GP-BMI data for calendar years 2011 to 2019 for 246,817 CYP, and CMP-BMI measures for 222,772 CYP, held within the Secure Anonymised Information Linkage Databank. We examined the proportion of CYP in Wales with at least one GP-BMI record, its distribution by child socio-demographic characteristics, and trends over time. We compared GP-BMI and CMP-BMI distributions. We quantified the proportion of children with a CMP-BMI measure and a follow-up GP-BMI recorded at an older age and explored the representativeness of these measures.Results: We identified a GP-BMI record in 246,817 (41%) CYP, present in a higher proportion of females (54.2%), infants (20.7%) and adolescents. There was no difference in the deprivation profile of those with a GP-BMI measurement. 31,521 CYP with a CMP-BMI had at least one follow-up GP-BMI; those with a CMP-BMI considered underweight or very overweight were 87% and 70% more likely to have at least one follow-up GP-BMI record respectively compared to those with a healthy weight, as were males and CYP living in the most deprived areas of Wales. Conclusions: Records of childhood weight status extracted from general practice are not representative of the population and are biased with respect to weight status. Linkage of information from the national programme to GP records has the potential to enhance discussions around healthy weight at the point of care but does not provide a representative estimate of population level weight trajectories, essential to provide insights into factors determining a healthy weight gain across the early life course. A second CMP measurement is required in Wales.</abstract><type>Journal Article</type><journal>PLOS ONE</journal><volume>19</volume><journalNumber>5</journalNumber><paginationStart>e0300221</paginationStart><paginationEnd/><publisher>Public Library of Science (PLoS)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1932-6203</issnElectronic><keywords/><publishedDay>10</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-05-10</publishedDate><doi>10.1371/journal.pone.0300221</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>This work was supported by the UK Medical Research Council (MRC) (Ref: MR/T039329/1), as part of the Built Environment and Child Health in Wales and Australia (BEACHES) study. It was further supported by Administrative Data Research (ADR) Wales (Ref: ES/W012227/1), part of the ADR UK investment, which unites research expertise from Swansea University Medical School and WISERD (Wales Institute of Social and Economic Research and Data) at Cardiff University with analysts from Welsh Government. ADR UK is funded by the Economic and Social Research Council (ESRC), part of UK Research and Innovation. NF and CD are supported by Barts Charity (Ref: MGU0419). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funders><projectreference/><lastEdited>2024-05-31T13:44:37.7457991</lastEdited><Created>2024-03-11T09:05:02.8608590</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Lucy</firstname><surname>Griffiths</surname><orcid>0000-0001-9230-624X</orcid><order>1</order></author><author><firstname>Jim</firstname><surname>Rafferty</surname><orcid>0000-0002-1667-7265</orcid><order>2</order></author><author><firstname>Rich</firstname><surname>Fry</surname><orcid>0000-0002-7968-6679</orcid><order>3</order></author><author><firstname>Helen</firstname><surname>Daniels</surname><orcid>0000-0001-8899-0333</orcid><order>4</order></author><author><firstname>Carol</firstname><surname>Dezateux</surname><orcid>0000-0001-9787-6276</orcid><order>5</order></author><author><firstname>Nicola</firstname><surname>Firman</surname><order>6</order></author><author><firstname>Theodora</firstname><surname>Pouliou</surname><order>7</order></author><author><firstname>Gareth</firstname><surname>Stratton</surname><orcid>0000-0001-5618-0803</orcid><order>8</order></author><author><firstname>Amy</firstname><surname>Mizen</surname><orcid>0000-0001-7516-6767</orcid><order>9</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>10</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>11</order></author><author><firstname>Jo</firstname><surname>Davis</surname><order>12</order></author><author><firstname>Rowena</firstname><surname>Bailey</surname><order>13</order></author></authors><documents><document><filename>65807__30499__08ced3fcd807415db2518c2b23428613.pdf</filename><originalFilename>65807.VoR.pdf</originalFilename><uploaded>2024-05-31T13:42:59.4331196</uploaded><type>Output</type><contentLength>994586</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2024 Griffiths et al. 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spelling v2 65807 2024-03-11 Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales e35ea6ea4b429e812ef204b048131d93 0000-0001-9230-624X Lucy Griffiths Lucy Griffiths true false 52effe759a718bd36eb12cdd10fe1a09 0000-0002-1667-7265 Jim Rafferty Jim Rafferty true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false a054902cb884be2476d0f097f0016294 0000-0001-8899-0333 Helen Daniels Helen Daniels true false 6d62b2ed126961bed81a94a2beba8a01 0000-0001-5618-0803 Gareth Stratton Gareth Stratton true false 9e9db8229784e27fcd79a14ee097e10b 0000-0001-7516-6767 Amy Mizen Amy Mizen true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 6bf610422e8243532d15fd62621f5946 Jo Davis Jo Davis true false 455e2c1e6193448f6269b9e72acaf865 Rowena Bailey Rowena Bailey true false 2024-03-11 MEDS Background: Routine monitoring of Body Mass Index (BMI) in general practice, and via national surveillance programmes, is essential for the identification, prevention, and management of unhealthy childhood weight. We examined and compared the presence and representativeness of children and young people's (CYPs) BMI recorded in two routinely collected administrative datasets: general practice electronic health records (GP-BMI) and the Child Measurement Programme for Wales (CMP-BMI), which measures height and weight in 4-5-year-old school children. We also assessed the feasibility of combining GP-BMI and CMP-BMI data for longitudinal analyses.Methods: We accessed de-identified population-level GP-BMI data for calendar years 2011 to 2019 for 246,817 CYP, and CMP-BMI measures for 222,772 CYP, held within the Secure Anonymised Information Linkage Databank. We examined the proportion of CYP in Wales with at least one GP-BMI record, its distribution by child socio-demographic characteristics, and trends over time. We compared GP-BMI and CMP-BMI distributions. We quantified the proportion of children with a CMP-BMI measure and a follow-up GP-BMI recorded at an older age and explored the representativeness of these measures.Results: We identified a GP-BMI record in 246,817 (41%) CYP, present in a higher proportion of females (54.2%), infants (20.7%) and adolescents. There was no difference in the deprivation profile of those with a GP-BMI measurement. 31,521 CYP with a CMP-BMI had at least one follow-up GP-BMI; those with a CMP-BMI considered underweight or very overweight were 87% and 70% more likely to have at least one follow-up GP-BMI record respectively compared to those with a healthy weight, as were males and CYP living in the most deprived areas of Wales. Conclusions: Records of childhood weight status extracted from general practice are not representative of the population and are biased with respect to weight status. Linkage of information from the national programme to GP records has the potential to enhance discussions around healthy weight at the point of care but does not provide a representative estimate of population level weight trajectories, essential to provide insights into factors determining a healthy weight gain across the early life course. A second CMP measurement is required in Wales. Journal Article PLOS ONE 19 5 e0300221 Public Library of Science (PLoS) 1932-6203 10 5 2024 2024-05-10 10.1371/journal.pone.0300221 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) This work was supported by the UK Medical Research Council (MRC) (Ref: MR/T039329/1), as part of the Built Environment and Child Health in Wales and Australia (BEACHES) study. It was further supported by Administrative Data Research (ADR) Wales (Ref: ES/W012227/1), part of the ADR UK investment, which unites research expertise from Swansea University Medical School and WISERD (Wales Institute of Social and Economic Research and Data) at Cardiff University with analysts from Welsh Government. ADR UK is funded by the Economic and Social Research Council (ESRC), part of UK Research and Innovation. NF and CD are supported by Barts Charity (Ref: MGU0419). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 2024-05-31T13:44:37.7457991 2024-03-11T09:05:02.8608590 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Lucy Griffiths 0000-0001-9230-624X 1 Jim Rafferty 0000-0002-1667-7265 2 Rich Fry 0000-0002-7968-6679 3 Helen Daniels 0000-0001-8899-0333 4 Carol Dezateux 0000-0001-9787-6276 5 Nicola Firman 6 Theodora Pouliou 7 Gareth Stratton 0000-0001-5618-0803 8 Amy Mizen 0000-0001-7516-6767 9 Ronan Lyons 0000-0001-5225-000X 10 Alan Watkins 0000-0003-3804-1943 11 Jo Davis 12 Rowena Bailey 13 65807__30499__08ced3fcd807415db2518c2b23428613.pdf 65807.VoR.pdf 2024-05-31T13:42:59.4331196 Output 994586 application/pdf Version of Record true © 2024 Griffiths et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
spellingShingle Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
Lucy Griffiths
Jim Rafferty
Rich Fry
Helen Daniels
Gareth Stratton
Amy Mizen
Ronan Lyons
Alan Watkins
Jo Davis
Rowena Bailey
title_short Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
title_full Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
title_fullStr Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
title_full_unstemmed Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
title_sort Children and young people’s body mass index measures derived from routine data sources: A national data linkage study in Wales
author_id_str_mv e35ea6ea4b429e812ef204b048131d93
52effe759a718bd36eb12cdd10fe1a09
d499b898d447b62c81b2c122598870e0
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6d62b2ed126961bed81a94a2beba8a01
9e9db8229784e27fcd79a14ee097e10b
83efcf2a9dfcf8b55586999d3d152ac6
81fc05c9333d9df41b041157437bcc2f
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author_id_fullname_str_mv e35ea6ea4b429e812ef204b048131d93_***_Lucy Griffiths
52effe759a718bd36eb12cdd10fe1a09_***_Jim Rafferty
d499b898d447b62c81b2c122598870e0_***_Rich Fry
a054902cb884be2476d0f097f0016294_***_Helen Daniels
6d62b2ed126961bed81a94a2beba8a01_***_Gareth Stratton
9e9db8229784e27fcd79a14ee097e10b_***_Amy Mizen
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
6bf610422e8243532d15fd62621f5946_***_Jo Davis
455e2c1e6193448f6269b9e72acaf865_***_Rowena Bailey
author Lucy Griffiths
Jim Rafferty
Rich Fry
Helen Daniels
Gareth Stratton
Amy Mizen
Ronan Lyons
Alan Watkins
Jo Davis
Rowena Bailey
author2 Lucy Griffiths
Jim Rafferty
Rich Fry
Helen Daniels
Carol Dezateux
Nicola Firman
Theodora Pouliou
Gareth Stratton
Amy Mizen
Ronan Lyons
Alan Watkins
Jo Davis
Rowena Bailey
format Journal article
container_title PLOS ONE
container_volume 19
container_issue 5
container_start_page e0300221
publishDate 2024
institution Swansea University
issn 1932-6203
doi_str_mv 10.1371/journal.pone.0300221
publisher Public Library of Science (PLoS)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Background: Routine monitoring of Body Mass Index (BMI) in general practice, and via national surveillance programmes, is essential for the identification, prevention, and management of unhealthy childhood weight. We examined and compared the presence and representativeness of children and young people's (CYPs) BMI recorded in two routinely collected administrative datasets: general practice electronic health records (GP-BMI) and the Child Measurement Programme for Wales (CMP-BMI), which measures height and weight in 4-5-year-old school children. We also assessed the feasibility of combining GP-BMI and CMP-BMI data for longitudinal analyses.Methods: We accessed de-identified population-level GP-BMI data for calendar years 2011 to 2019 for 246,817 CYP, and CMP-BMI measures for 222,772 CYP, held within the Secure Anonymised Information Linkage Databank. We examined the proportion of CYP in Wales with at least one GP-BMI record, its distribution by child socio-demographic characteristics, and trends over time. We compared GP-BMI and CMP-BMI distributions. We quantified the proportion of children with a CMP-BMI measure and a follow-up GP-BMI recorded at an older age and explored the representativeness of these measures.Results: We identified a GP-BMI record in 246,817 (41%) CYP, present in a higher proportion of females (54.2%), infants (20.7%) and adolescents. There was no difference in the deprivation profile of those with a GP-BMI measurement. 31,521 CYP with a CMP-BMI had at least one follow-up GP-BMI; those with a CMP-BMI considered underweight or very overweight were 87% and 70% more likely to have at least one follow-up GP-BMI record respectively compared to those with a healthy weight, as were males and CYP living in the most deprived areas of Wales. Conclusions: Records of childhood weight status extracted from general practice are not representative of the population and are biased with respect to weight status. Linkage of information from the national programme to GP records has the potential to enhance discussions around healthy weight at the point of care but does not provide a representative estimate of population level weight trajectories, essential to provide insights into factors determining a healthy weight gain across the early life course. A second CMP measurement is required in Wales.
published_date 2024-05-10T13:44:36Z
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