Completeness and accuracy of anthropometric measurements in electronic medical records for children attending primary care

Background — Electronic medical records (EMRs) from primary care may be a feasible source of height and weight data. However the use of EMRs in research has been impeded by lack of standardization of EMRs systems, data access and concerns about the quality of the data.

Objectives — The study objectives were to determine the data completeness and accuracy of child heights and weights collected in primary care EMRs, and to identify factors associated with these data quality attributes.

Methods — A cross-sectional study examining height and weight data for children <19 years from EMRs through the Electronic Medical Records Administrative data Linked Database (EMRALD), a network of family practices across the province of Ontario. Body mass index z-scores were calculated using the WHO Growth Standards and Reference.

Results — A total of 54,964 children were identified from EMRALD. Overall, 93% had at least 1 complete set of growth measurements to calculate a BMI z-score. 66.2% of all primary care visits had complete BMI z-score data. After stratifying by visit type 89.9% of well-child visits and 33.9% of sick visits had complete BMI z-score data; incomplete BMI z-score was mainly due to missing height measurements. Only 2.7% of BMI z-score data were excluded due to implausible values.

Conclusions — Data completeness at well-child visits and overall data accuracy were greater than 90%. EMRs may be a valid source of data to provide estimates of obesity in children who attend primary care.