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Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records

Michael Childs, Sarah Aldridge, Helen Daniels Orcid Logo, Gareth Ivor Davies, Victoria Best, Hoda Abbasizanjani Orcid Logo, Ronan Lyons, Ashley Akbari Orcid Logo, Fatemeh Torabi Orcid Logo

BMJ Open, Volume: 15, Issue: 10, Start page: e103724

Swansea University Authors: Michael Childs, Sarah Aldridge, Helen Daniels Orcid Logo, Victoria Best, Hoda Abbasizanjani Orcid Logo, Ronan Lyons, Ashley Akbari Orcid Logo, Fatemeh Torabi Orcid Logo

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DOI (Published version): 10.1136/bmjopen-2025-103724

Abstract

Objective This study aims to develop a methodology to retrieve, harmonise and evaluate the completeness of national body mass index (BMI) data from linked electronic health record (EHR) sources to build a longitudinal research-ready data asset (RRDA).Design A longitudinal study of BMI records spanni...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70456
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The methodology is adaptable across different trusted research environments. We evaluated the completeness and retention of records over 1-, 5- and 23-year periods by calculating the proportion of missing data relative to each year&#x2019;s population.Results We retrieved 53.4&#x2009;million records for 3.2&#x2009;million individuals across Wales from 1st January 2000 to 31 December 2022. Among these, 3% of CYP and 34% of adults had repeat BMI measurements recorded over periods ranging from 5 to 23 years. Throughout the entire population of Wales during this period, 49% of CYP and 26% of adults had at least one BMI reading recorded, resulting in a missingness rate of 51% for CYP and 74% for adults. Preserving BMI information by retaining the most recently recorded BMI over 1-, 5- and 23-year intervals from 2022 showed coverage rates of 10%, 33% and 68%, respectively, for CYP, and 25%, 51% and 73%, respectively, for adults.Conclusions Our findings highlight substantial variations in BMI data availability and retention across CYP and adults, as well as time periods within EHR in Wales. 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spelling 2025-10-06T09:48:13.6288179 v2 70456 2025-09-22 Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records 078f33ed8828ac25a9ba8439b9cd892d Michael Childs Michael Childs true false a42ee8ba1ff8174d5bb62d2d95364b90 Sarah Aldridge Sarah Aldridge true false a054902cb884be2476d0f097f0016294 0000-0001-8899-0333 Helen Daniels Helen Daniels true false 0c82f7076d0fc5c916ecbcc472a6a9ae Victoria Best Victoria Best true false 93dd7e747f3118a99566c68592a3ddcc 0000-0002-9575-4758 Hoda Abbasizanjani Hoda Abbasizanjani true false 83efcf2a9dfcf8b55586999d3d152ac6 Ronan Lyons Ronan Lyons true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false 2025-09-22 Objective This study aims to develop a methodology to retrieve, harmonise and evaluate the completeness of national body mass index (BMI) data from linked electronic health record (EHR) sources to build a longitudinal research-ready data asset (RRDA).Design A longitudinal study of BMI records spanning 23 years (1 January 2000 to 31 December 2022) from four data sources.Setting The national BMI RRDA is created within the Secure Anonymised Information Linkage (Databank), encompassing the entire population of Wales, UK.Procedure and participants We built a methodology that provides a reproducible framework for extracting and harmonising BMI data from four major linked EHRs across two age groups: children and young people (CYP; 2–18 years old) and adults (19 years and older). The methodology is adaptable across different trusted research environments. We evaluated the completeness and retention of records over 1-, 5- and 23-year periods by calculating the proportion of missing data relative to each year’s population.Results We retrieved 53.4 million records for 3.2 million individuals across Wales from 1st January 2000 to 31 December 2022. Among these, 3% of CYP and 34% of adults had repeat BMI measurements recorded over periods ranging from 5 to 23 years. Throughout the entire population of Wales during this period, 49% of CYP and 26% of adults had at least one BMI reading recorded, resulting in a missingness rate of 51% for CYP and 74% for adults. Preserving BMI information by retaining the most recently recorded BMI over 1-, 5- and 23-year intervals from 2022 showed coverage rates of 10%, 33% and 68%, respectively, for CYP, and 25%, 51% and 73%, respectively, for adults.Conclusions Our findings highlight substantial variations in BMI data availability and retention across CYP and adults, as well as time periods within EHR in Wales. Wider adoption of this approach can enhance standardised approaches in using accessible measures like BMI to assess disease risk in population-based studies, strengthening public health initiatives and research efforts. Journal Article BMJ Open 15 10 e103724 BMJ 2044-6055 2044-6055 5 10 2025 2025-10-05 10.1136/bmjopen-2025-103724 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) ADR; Economic and Social Research Council - ES/W012227/1; HDR UK Ltd - HDR-9006; Medical Research Council - MR/V028367/1 2025-10-06T09:48:13.6288179 2025-09-22T13:34:31.7575802 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Michael Childs 1 Sarah Aldridge 2 Helen Daniels 0000-0001-8899-0333 3 Gareth Ivor Davies 4 Victoria Best 5 Hoda Abbasizanjani 0000-0002-9575-4758 6 Ronan Lyons 7 Ashley Akbari 0000-0003-0814-0801 8 Fatemeh Torabi 0000-0002-5853-4625 9 70456__35247__2eeef503f5354884bc972f69796fce50.pdf 70456.VoR.pdf 2025-10-06T09:45:38.1570908 Output 3141272 application/pdf Version of Record true © Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license. true eng https://creativecommons.org/licenses/by/4.0/
title Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
spellingShingle Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
Michael Childs
Sarah Aldridge
Helen Daniels
Victoria Best
Hoda Abbasizanjani
Ronan Lyons
Ashley Akbari
Fatemeh Torabi
title_short Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
title_full Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
title_fullStr Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
title_full_unstemmed Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
title_sort Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records
author_id_str_mv 078f33ed8828ac25a9ba8439b9cd892d
a42ee8ba1ff8174d5bb62d2d95364b90
a054902cb884be2476d0f097f0016294
0c82f7076d0fc5c916ecbcc472a6a9ae
93dd7e747f3118a99566c68592a3ddcc
83efcf2a9dfcf8b55586999d3d152ac6
aa1b025ec0243f708bb5eb0a93d6fb52
f569591e1bfb0e405b8091f99fec45d3
author_id_fullname_str_mv 078f33ed8828ac25a9ba8439b9cd892d_***_Michael Childs
a42ee8ba1ff8174d5bb62d2d95364b90_***_Sarah Aldridge
a054902cb884be2476d0f097f0016294_***_Helen Daniels
0c82f7076d0fc5c916ecbcc472a6a9ae_***_Victoria Best
93dd7e747f3118a99566c68592a3ddcc_***_Hoda Abbasizanjani
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi
author Michael Childs
Sarah Aldridge
Helen Daniels
Victoria Best
Hoda Abbasizanjani
Ronan Lyons
Ashley Akbari
Fatemeh Torabi
author2 Michael Childs
Sarah Aldridge
Helen Daniels
Gareth Ivor Davies
Victoria Best
Hoda Abbasizanjani
Ronan Lyons
Ashley Akbari
Fatemeh Torabi
format Journal article
container_title BMJ Open
container_volume 15
container_issue 10
container_start_page e103724
publishDate 2025
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2025-103724
publisher BMJ
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
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description Objective This study aims to develop a methodology to retrieve, harmonise and evaluate the completeness of national body mass index (BMI) data from linked electronic health record (EHR) sources to build a longitudinal research-ready data asset (RRDA).Design A longitudinal study of BMI records spanning 23 years (1 January 2000 to 31 December 2022) from four data sources.Setting The national BMI RRDA is created within the Secure Anonymised Information Linkage (Databank), encompassing the entire population of Wales, UK.Procedure and participants We built a methodology that provides a reproducible framework for extracting and harmonising BMI data from four major linked EHRs across two age groups: children and young people (CYP; 2–18 years old) and adults (19 years and older). The methodology is adaptable across different trusted research environments. We evaluated the completeness and retention of records over 1-, 5- and 23-year periods by calculating the proportion of missing data relative to each year’s population.Results We retrieved 53.4 million records for 3.2 million individuals across Wales from 1st January 2000 to 31 December 2022. Among these, 3% of CYP and 34% of adults had repeat BMI measurements recorded over periods ranging from 5 to 23 years. Throughout the entire population of Wales during this period, 49% of CYP and 26% of adults had at least one BMI reading recorded, resulting in a missingness rate of 51% for CYP and 74% for adults. Preserving BMI information by retaining the most recently recorded BMI over 1-, 5- and 23-year intervals from 2022 showed coverage rates of 10%, 33% and 68%, respectively, for CYP, and 25%, 51% and 73%, respectively, for adults.Conclusions Our findings highlight substantial variations in BMI data availability and retention across CYP and adults, as well as time periods within EHR in Wales. Wider adoption of this approach can enhance standardised approaches in using accessible measures like BMI to assess disease risk in population-based studies, strengthening public health initiatives and research efforts.
published_date 2025-10-05T05:32:57Z
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