Recognition, diagnostic practices, and cancer outcomes among patients with unintentional weight loss (UWL) in primary care
Author:
Rao Goutham1, Ufholz Kelsey1ORCID, Saroufim Paola1, Menegay Harry2, Beno Mark3
Affiliation:
1. Department of Family Medicine and Community Health , Case Western Reserve University School of Medicine , Cleveland , OH , USA 2. University Hospitals of Cleveland , Cleveland , OH , USA 3. Population & Quantitative Health Sciences , Case Western Reserve University School of Medicine , Cleveland , OH , USA
Abstract
Abstract
Objectives
Identify the incidence, rate of physician recognition, diagnostic practices and cancer outcomes for unintentional weight loss (UWL).
Methods
We completed a secondary analysis of structured and unstructured EHR data collected from adult patients between January 1, 2020 and December 31, 2021. We used four common definitions to define UWL, excluding patients with known causes of weight loss, intentional weight loss, and pregnancy. Unstructured physicians’ notes were used to identify both intentional weight loss (e.g. dieting) as well as physician recognition of UWL. Cancer outcomes were identified within 12 months of UWL using diagnostic codes. Physician actions (lab tests, etc.) in response to UWL were identified through manual chart review.
Results
Among 29,494 established primary care patients with a minimum of two weight measurements in 2020 and in 2021, we identified 290 patients who met one or more criteria for UWL (1 %). UWL was recognized by physicians in only 60 (21 %). UWL was more common and more likely to be recognized among older patients. Diagnostic practices were quite variable. A complete blood count, complete metabolic profile, and thyroid stimulating hormone level were the three most common tests ordered in response to UWL. Five patients were diagnosed with cancer within 12 months of UWL (3 in whom UWL was recognized; two in whom it was not.)
Conclusions
Unintentional weight loss is poorly recognized across a diverse range of patients. A lack of research-informed guidance may explain both low rates of recognition and variability in diagnostic practices.
Funder
Agency for Healthcare Research and Quality
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)
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