Low levels of knowledge on the assessment of underweight in children and adolescents among middle-grade doctors in England and Wales
- Lee D Hudson1,
- Charlotte Cumby1,
- Robert E Klaber2,
- Dasha E Nicholls3,
- Paul J Winyard1,
- Russell M Viner1
- 1General and Adolescent Paediatric Unit, UCL Institute of Child Health, London, UK
- 2Department of Paediatrics, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
- 3Feeding and Eating Disorders Team, Great Ormond Street Hospital, London, UK
- Correspondence to Dr Lee D Hudson, General and Adolescent Paediatric Unit, UCL Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK;
- Received 7 November 2012
- Revised 8 January 2013
- Accepted 9 January 2013
- Published Online First 31 January 2013
Background Safe assessment of severe underweight in children is important but experience suggests a frequent lack of understanding. Here we sought evidence from a wide spectrum of trainees.
Methods Cross-sectional telephone survey of an on-call middle-grade paediatric doctor in hospitals providing acute inpatient general paediatric care in England and Wales.
Results Response rate was 100%. Only 50% identified BMI as the appropriate measure for underweight in children. Most did not identify any clinical cardiovascular complications of severe underweight. Only 13% identified corrected QT time (QTc) as an important ECG finding. Knowledge of the refeeding syndrome was poor with 20% unable to define it at all, 21% able to identify some clinical features and 57% aware of potential phosphate abnormalities.
Conclusions Knowledge base among middle-grades doctors in England and Wales on this topic is worryingly poor, particularly in relation to several life-threatening features. Existing and new training approaches should recognise this.