Abstract：
OBJECTIVE: Determine screening rates and examine socio-demographic characteristics of metabolic dysfunction-associated steatotic liver disease (MAFLD) screening in a large population of obese children.
METHODS: We used Explorys (IBM) which contains aggregated population-level electronic health record data from approximately 360 hospitals and 317,000 providers across the United States to determine MAFLD screening rates. In children 10 to 14 years, obesity was determined based on body mass index ≥ 95%, or encounter with an international classification of disease obesity code. We determined screening rates by calculating the percentage of children with obesity who had an alanine aminotransferase tested, further analyzed by gender, race, and insurance.
RESULTS: Of 3,558,420 children, 513,170 (14.4%) were obese. Of obese children, only 9.3% were screened for MAFLD. Females were more likely screened than males (odds ratio (OR) 1.09 (95% confidence intervals (CI): 1.07-1.12)); White children were more likely screened than non-White children (OR 1.21 (95% CI: 1.18-1.23)), and children with Medicaid more likely screened than children with non-Medicaid insurance (OR 1.34 (95% CI: 1.32-1.37)).
CONCLUSIONS: The percentage of obese children receiving screening for MAFLD was low. Female gender, White race, and Medicaid insurance were associated with increased screening rates. These findings highlight the need to increase adherence to MAFLD screening. Reporting screening as a health quality measure may reduce implementation gaps in MAFLD screening.
METHODS: We used Explorys (IBM) which contains aggregated population-level electronic health record data from approximately 360 hospitals and 317,000 providers across the United States to determine MAFLD screening rates. In children 10 to 14 years, obesity was determined based on body mass index ≥ 95%, or encounter with an international classification of disease obesity code. We determined screening rates by calculating the percentage of children with obesity who had an alanine aminotransferase tested, further analyzed by gender, race, and insurance.
RESULTS: Of 3,558,420 children, 513,170 (14.4%) were obese. Of obese children, only 9.3% were screened for MAFLD. Females were more likely screened than males (odds ratio (OR) 1.09 (95% confidence intervals (CI): 1.07-1.12)); White children were more likely screened than non-White children (OR 1.21 (95% CI: 1.18-1.23)), and children with Medicaid more likely screened than children with non-Medicaid insurance (OR 1.34 (95% CI: 1.32-1.37)).
CONCLUSIONS: The percentage of obese children receiving screening for MAFLD was low. Female gender, White race, and Medicaid insurance were associated with increased screening rates. These findings highlight the need to increase adherence to MAFLD screening. Reporting screening as a health quality measure may reduce implementation gaps in MAFLD screening.
摘要：
目的：在大量肥胖儿童中确定筛查率并检查MAFLD筛查的社会人口学特征。
方法：我们使用Explorys（IBM），其中包含来自美国约360家医院和317,000家提供商的汇总人口级电子健康记录数据，以确定MAFLD筛查率。在10-14岁的儿童中，肥胖是基于BMI>=95%，或者遇到ICD肥胖代码。我们通过计算患有丙氨酸转氨酶（ALT）的肥胖儿童的百分比来确定筛查率，进一步按性别分析，种族和保险。
结果：在3,558,420名儿童中，513,170（14.4%）肥胖。在肥胖儿童中，只有9.3%的患者接受了NAFLD筛查.女性比男性更有可能进行筛查（比值比（OR）1.09（95％CI：1.07-1.12））；白人儿童比非白人儿童更有可能进行筛查（OR1.21（95％CI：1.18-1.23）），接受医疗补助的儿童比非医疗补助保险的儿童更有可能进行筛查(OR1.34(95%CI:1.32-1.37))。
结论：接受MAFLD筛查的肥胖儿童比例较低。女性性别,白人种族,和医疗补助保险与增加筛查率相关。这些发现强调了提高MAFLD筛查依从性的必要性。将筛查报告为健康质量措施可能会减少MAFLD筛查的实施差距。这项研究有什么新发现？：我们的研究增加了有关儿童MAFLD筛查的筛查率和社会人口统计学特征的知识。
方法：我们使用Explorys（IBM），其中包含来自美国约360家医院和317,000家提供商的汇总人口级电子健康记录数据，以确定MAFLD筛查率。在10-14岁的儿童中，肥胖是基于BMI>=95%，或者遇到ICD肥胖代码。我们通过计算患有丙氨酸转氨酶（ALT）的肥胖儿童的百分比来确定筛查率，进一步按性别分析，种族和保险。
结果：在3,558,420名儿童中，513,170（14.4%）肥胖。在肥胖儿童中，只有9.3%的患者接受了NAFLD筛查.女性比男性更有可能进行筛查（比值比（OR）1.09（95％CI：1.07-1.12））；白人儿童比非白人儿童更有可能进行筛查（OR1.21（95％CI：1.18-1.23）），接受医疗补助的儿童比非医疗补助保险的儿童更有可能进行筛查(OR1.34(95%CI:1.32-1.37))。
结论：接受MAFLD筛查的肥胖儿童比例较低。女性性别,白人种族,和医疗补助保险与增加筛查率相关。这些发现强调了提高MAFLD筛查依从性的必要性。将筛查报告为健康质量措施可能会减少MAFLD筛查的实施差距。这项研究有什么新发现？：我们的研究增加了有关儿童MAFLD筛查的筛查率和社会人口统计学特征的知识。
