Inverse-probability weighting and multiple imputation for evaluating selection bias in the estimation of childhood obesity prevalence using data from electronic health records
Inverse-probability weighting and multiple imputation for evaluating selection bias in the estimation of childhood obesity prevalence using data from electronic health records
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DOI：
10.1186/s12911-020-1020-8
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发表时间：
2020-01-20
影响因子：
3.5
通讯作者：
Guevara, Marcela
中科院分区：
文献类型：
--
作者：
Sayon-Orea, Carmen;Moreno-Iribas, Conchi;Guevara, Marcela
背景和目的来自电子健康记录的身高和体重数据正越来越多地被用于估计儿童肥胖症的流行率。在这里，我们的目标是评估由于五岁以上儿童电子健康记录中丢失的体重和身高数据而造成的选择偏差。方法对2002年至2003年在西班牙纳瓦拉出生的10,811名儿童进行队列研究，这些儿童到2016年12月仍生活在该地区。考虑到与体重相关的变量(性别、农村或城市居住地、家庭收入和2-5岁时的体重状况)，我们检查了5岁以上测量儿童和未测量儿童之间的差异。这些变量被用来计算反概率加权的稳定权重，并对缺失数据进行多次填补。对6~14岁、6~9岁和10~14岁人群，采用逆概率加权和多重推算的方法计算完整资料患病率和考虑缺失资料的调整患病率。结果6~9年全资料、逆概率加权和多重推算肥胖年龄调整患病率为13.18%(95%CI：12.54~13.85)，10~14年分别为13.22%(95%CI：12.57~13.89)和13.02%(95%CI：12.38~13.66)和8.61%(95%CI：8.06~9.18)、8.62%(95%CI：8.06~9.20)和8.24%(95%CI：7.70~8.78)。结论对于6~9岁和10~14岁两个年龄段的健康儿童，使用完整数据、多重归因和逆概率加权估计体重状况是相似的。随时可用的电子健康记录数据可能是监测儿童体重状况的工具。
Background and objectives Height and weight data from electronic health records are increasingly being used to estimate the prevalence of childhood obesity. Here, we aim to assess the selection bias due to missing weight and height data from electronic health records in children older than five. Methods Cohort study of 10,811 children born in Navarra (Spain) between 2002 and 2003, who were still living in this region by December 2016. We examined the differences between measured and non-measured children older than 5 years considering weight-associated variables (sex, rural or urban residence, family income and weight status at 2-5 yrs). These variables were used to calculate stabilized weights for inverse-probability weighting and to conduct multiple imputation for the missing data. We calculated complete data prevalence and adjusted prevalence considering the missing data using inverse-probability weighting and multiple imputation for ages 6 to 14 and group ages 6 to 9 and 10 to 14. Results For 6-9 years, complete data, inverse-probability weighting and multiple imputation obesity age-adjusted prevalence were 13.18% (95% CI: 12.54-13.85), 13.22% (95% CI: 12.57-13.89) and 13.02% (95% CI: 12.38-13.66) and for 10-14 years 8.61% (95% CI: 8.06-9.18), 8.62% (95% CI: 8.06-9.20) and 8.24% (95% CI: 7.70-8.78), respectively. Conclusions Ages at which well-child visits are scheduled and for the 6 to 9 and 10 to 14 age groups, weight status estimations are similar using complete data, multiple imputation and inverse-probability weighting. Readily available electronic health record data may be a tool to monitor the weight status in children.