Obesity Diagnosis and Care Practices in the Veterans Health Administration

Noël, Polly Hitchcock; Copeland, Laurel A.; Pugh, Mary Jo; Kahwati, Leila C.; Tsevat, Joel; Nelson, Karin M.; Wang, Chen Pin; Bollinger, Mary; Hazuda, Helen P.

doi:10.1007/s11606-010-1279-z

Cited by 46 publications

(50 citation statements)

References 20 publications

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“…The first challenge was that significantly more weights were recorded in the national and regional data sources than heights, a finding that has been noted elsewhere and probably reflects clinical practice [11][12][13]. Failure to record heights as frequently as weights could be due to a number of factors, including lack of proper equipment, low perceived importance, time constraints, and competing clinical demands [11][12]18].…”

Section: Challengesmentioning

confidence: 99%

“…[10]. Although a few individuals may have heights and/or weights outside these ranges, only a small number of patients (n = 70) in our cohort were eliminated because they only had biologically implausible values [13]. Depending on the population being studied, however, researchers should select height and weight ranges that make sense with their populations (e.g., patients with cancer).…”

Section: Strategies To Address Challenges In Future Researchmentioning

confidence: 99%

“…Clinical data most relevant to investigations of obesity include ICD-9-CM (International Classification of Diseases-9th Revision, Clinical Modification) diagnoses and anthropometric measurements. Unfortunately, a number of recent studies indicate that obesity is underdiagnosed, especially among primary care patients [11][12][13]. Therefore, access to anthropometric measurements is critical for accurately identifying obese patients, the care they receive, and their outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Data required for this study included height and weight to define a cohort of obese patients and track BMI outcomes [13]. Given the novelty of the CDW data, an assessment of data completeness and accuracy was also seen as essential to ensure the integrity of the research.…”

Section: Introductionmentioning

confidence: 99%

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VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Noël¹,

Copeland²,

Perrin³

et al. 2010

JRRD

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Abstract-Within the Veterans Health Administration (VHA), anthropometric measurements entered into the electronic medical record are stored in local information systems, the national Corporate Data Warehouse (CDW), and in some regional data warehouses. This article describes efforts to examine the quality of weight and height data within the CDW and to compare CDW data with data from warehouses maintained by several of VHA's regional groupings of healthcare facilities (Veterans Integrated Service Networks [VISNs]). We found significantly fewer recorded heights than weights in both the CDW and VISN data sources. In spite of occasional anomalies, the concordance in the number and value of records in the CDW and the VISN warehouses was generally 97% to 99% or greater. Implausible variation in same-day and same-year heights and weights was noted, suggesting measurement or data-entry errors. Our work suggests that the CDW, over time and through validation, has become a generally reliable source of anthropometric data. Researchers should assess the reliability of data contained within any source and apply strategies to minimize the impact of data errors appropriate to their study population.

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Section: Challengesmentioning

confidence: 99%

Section: Strategies To Address Challenges In Future Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Noël¹,

Copeland²,

Perrin³

et al. 2010

JRRD

Self Cite

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show abstract

“…There is a wealth of data describing high-prevalence, high-impact multimorbidity among Veterans in general [21][22][23]. There is also a wealth of data describing comorbidities among Veterans with overweight/obesity, such as hypertension (HTN), type 2 diabetes, hypercholesterolemia, and heart disease [7,24], as well as alcohol and drug use disorders, depression, and posttraumatic stress disorder (PTSD) [24]. The same is true for correlates of pain and painful conditions among Veterans, including overweight/obesity, anxiety disorders, PTSD, mood disorders, and substance use disorders [25][26].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of painful conditions and multimorbidity in national sample of overweight/obese Veterans

Higgins

Buta²,

Dorflinger³

et al. 2016

J Rehabil Res Dev

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Abstract-Chronic pain and overweight/obesity are prevalent public health concerns and occur at particularly high rates among Veterans. This study examined the prevalence and correlates of two common painful conditions (back pain and arthritis/ joint pain) among overweight/obese Veterans in Veterans Health Administration (VHA) care. Participants (N = 45,477) completed the MOVE!23, a survey intended to tailor treatment for Veterans in VHA's MOVE! weight-management program. Overall, 72% of the sample reported painful conditions, with 10% reporting back pain, 26% reporting arthritis/joint pain, and 35% reporting both. We used multinomial logistic regression with "no pain" as the reference category to examine the association between painful conditions and participant characteristics. After multivariable adjustment, female Veterans had higher odds of reporting arthritis/joint pain and combined back and arthritis/ joint pain than no pain. Participants with higher body mass index had higher odds of reporting arthritis/joint pain and both back and arthritis/joint pain. The likelihood of painful conditions was higher in Veterans with comorbidities (hypertension, hyperlipidemia, lung disease, depression, anxiety, or posttraumatic stress disorder) and generally increased with the number of comorbidities reported (i.e., 5 or more). Overweight/obese Veterans frequently report painful conditions and, among those with pain, often have multiple comorbidities. These factors may increase the complexity of clinical management and necessitate refinements to weight-management programs.

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Relationships between patterns of weight‐related self‐monitoring and eating disorder symptomology among undergraduate and graduate students

Hahn

Bauer

Kaciroti

et al. 2021

Intl J Eating Disorders

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Objective To characterize patterns of weight‐related self‐monitoring (WRSM) among US undergraduate and graduate students and examine associations between identified patterns of WRSM and eating disorder symptomology. Method Undergraduate and graduate students from 12 US colleges and universities (N = 10,010) reported the frequency with which they use WRSM, including self‐weighing and dietary self‐monitoring. Eating disorder symptomology was assessed using the Eating Disorder Examination Questionnaire. Gender‐specific patterns of WRSM were identified using latent class analysis, and logistic regressions were used to identify differences in the odds of eating disorder symptomology across patterns of WRSM. Results Among this sample, 32.7% weighed themselves regularly; 44.1% reported knowing the nutrition facts of the foods they ate; 33.6% reported knowing the caloric content of the foods they ate; and 12.8% counted the calories they ate. Among women, four patterns of WRSM were identified: “no WRSM,” “all forms of WRSM,” “knowing nutrition/calorie facts,” and “self‐weigh only.” Compared with the “no WRSM” pattern, women in all other patterns experienced increased eating disorder symptomology. Among men, three patterns were identified: “no WRSM,” “all forms of WRSM,” and “knowing nutrition/calorie facts.” Only men in the “all forms WRSM” pattern had increased eating disorder symptomatology compared with those in the “no WRSM” pattern. Discussion In a large sample of undergraduate and graduate students, engaging in any WRSM was associated with increased eating disorder symptomology among women, particularly for those who engaged in all forms. Among men, engaging in all forms of WRSM was the only pattern associated with higher eating disorder symptomology.

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Obesity Diagnosis and Care Practices in the Veterans Health Administration

Cited by 46 publications

References 20 publications

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Prevalence and correlates of painful conditions and multimorbidity in national sample of overweight/obese Veterans

Relationships between patterns of weight‐related self‐monitoring and eating disorder symptomology among undergraduate and graduate students

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