Evaluating the Effectiveness of a Clinical Practice Intervention in Increasing Obesity Data Recording at a Western Australian Country Health Service Hospital: A Quasi-Experimental Controlled Trial

Figures & data

Table 1 WACHS Patient Admission Obesity Accuracy and Inter-Rater Reliability Analysis

	2017/18 Data Collection					2021 Intervention Site	2021 Control Site
	All	Site A	Site B	Site C	Site D	Site A2	Site E
Records within research criteria	847	209	199	219	220	220	170
Records audited	590	166	100	158	166	166	113
Male	297 (50.3%)	87 (52%)	52 (52%)	78 (49%)	80 (48%)	76 (46%)	43 (38%)
Female	293 (49.7%)	79 (48%)	48 (48%)	80 (51%)	86 (52%)	90 (54%)	70 (62%)
18–24 years	6 (1%)	0 (0%)	1 (1%)	0 (0%)	5 (3%)	3 (2%)	3 (3%)
25–34 years	27 (5%)	4 (2%)	8 (8%)	1 (1%)	14 (8%)	5 (3%)	8 (7%)
35–44 years	56 (9%)	1 (1%)	24 (24%)	2 (1%)	29 (17%)	5 (3%)	11 (10%)
45–54 years	61 (10%)	5 (3%)	21 (21%)	8 (5%)	27 (16%)	6 (4%)	9 (8%)
55–64 years	91 (15%)	20 (12%)	24 (24%)	17 (11%)	30 (18%)	12 (7%)	21 (18%)
65–74 years	116 (20%)	32 (19%)	12 (12%)	44 (28%)	28 (17%)	44 (26%)	17 (15%)
75+ years	233 (39%)	104 (63%)	10 (10%)	86 (54%)	33 (20%)	91 (55%)	44 (39%)
Coded as obese (n, %)	64 (10.8%)	14 (8.4%)	3 (3.0%)	16 (10.1%)	31 (18.6%)	17 (10.2%)	16 (14.1%)
Weight recorded	397 (67.3%)	94 (56.6%)	70 (70.0%)	100 (63.3%)	133 (80.1%)	96 (57.8%)	99 (87.6%)
Height recorded	142 (24.1%)	21 (12.6%)	9 (9.0%)	33 (20.1%)	79 (47.6%)	55 (33.1%)	50 (37.6%)
BMI calculated	64 (10.8%)	10 (6.0%)	7 (7.0%)	19 (12.0%)	28 (16.9%)	56 (33.7%)	14 (10.5%)
Height and weight recorded, no BMI	88 (62.0%)	12 (57.1%)	8 (88.8%)	14 (42.4%)	54 (68.3%)	12 (21.8%)	37 (74%)
Obesity or BMI notations recorded	115 (19.4%)	27 (16.2%)	12 (12.0%)	34 (21.5%)	42 (25.3%)	22 (13.2%)	18 (13.5%)
Obesity or BMI notations recorded but height and weight not recorded	55 (9.3%)	21 (12.6%)	11 (11.0%)	12 (7.5%)	11 (6.6%)	14 (12.6%)	7 (11.1%)
Sensitivity	40.0%	48.1%	8.3%	35.3%	47.6%	59.1%	72.2%
Specificity	96.2%	99.3%	97.7%	96.8%	91.1%	96.5%	96.8%
NPV	86.9%	90.8%	88.6%	84.5%	83.7%	93.9%	94.8%
PPV	71.8%	92.9%	33.3%	75.0%	64.5%	72.2%	81.2%
False positive	3.8%	0.7%	2.3%	3.2%	8.9%	3.5%	3.2%
False negative	60.0%	51.9%	91.7%	64.7%	52.4%	40.9%	27.8%
Kappa	0.44	0.59	0.09	0.40	0.42	0.6%	0.72%

Table 2 WACHS Patient Obesity Recording Characteristics and Intervention Outcomes

	Site A Pre-Intervention	Site A – Intervention	Difference in Proportions
Records within research criteria	209	220	11
Records audited	166	166	0
Coded as obese (n, %)	14 (8.4%)	17 (10.2%)	3 (1.8% ↑)
Weight recorded	94 (56.6%)	96 (57.8%)	2 (1.2% ↑)
Height recorded	21 (12.6%)	55 (33.1%)	34 (20.5% ↑)
BMI calculated	10 (6.0%)	56 (33.7%)	46 (27.7% ↑)
Height and weight recorded, no BMI	12 (57.1%)	12 (21.8%)	0 (35.3% ↓)
Obesity or BMI notations recorded	27 (16.2%)	22 (13.2%)	5 (3% ↓)
Obesity or BMI notations recorded but height and weight not recorded	21 (12.6%)	14 (12.6%)	2 (stable)
Sensitivity	48.1%	59.1%	11% ↑
Specificity	99.3%	96.5%	2.8% ↓
NPV	90.8%	93.9%	3.1% ↑
PPV	92.9%	72.2%	20.7% ↓
False positive	0.7%	3.5%	2.8% ↑
False negative	51.9%	40.9%	11% ↓
Kappa	0.59	0.6%	0.01% ↑

Notes: ↑ Indicates an increase; ↓ Indicates a decrease.

Figure 1 WACHS obesity recording pre- and post-intervention.

Figure 2 WACHS obesity data sensitivity and specificity: pre- and post-intervention.