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Low levels of knowledge on the assessment of underweight in children and adolescents among middle-grade doctors in England and Wales
  1. Lee D Hudson1,
  2. Charlotte Cumby1,
  3. Robert E Klaber2,
  4. Dasha E Nicholls3,
  5. Paul J Winyard1,
  6. Russell M Viner1
  1. 1General and Adolescent Paediatric Unit, UCL Institute of Child Health, London, UK
  2. 2Department of Paediatrics, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
  3. 3Feeding and Eating Disorders Team, Great Ormond Street Hospital, London, UK
  1. Correspondence to Dr Lee D Hudson, General and Adolescent Paediatric Unit, UCL Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK; l.hudson{at}


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.

  • General Paediatrics
  • Growth
  • Health Service
  • Measurement
  • Paediatric Practice

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