Characterizing clinical pediatric obesity subtypes using electronic health record data

In this work, we present a study of electronic health record (EHR) data that aims to identify pediatric obesity clinical subtypes. Specifically, we examine whether certain temporal condition patterns associated with childhood obesity incidence tend to cluster together to characterize subtypes of clinically similar patients. In a previous study, the sequence mining algorithm, SPADE was implemented on EHR data from a large retrospective cohort (n = 49 594 patients) to identify common condition trajectories surrounding pediatric obesity incidence. In this study, we used Latent Class Analysis (LCA) to identify potential subtypes formed by these temporal condition patterns. The demographic characteristics of patients in each subtype are also examined. An LCA model with 8 classes was developed that identified clinically similar patient subtypes. Patients in Class 1 had a high prevalence of respiratory and sleep disorders, patients in Class 2 had high rates of inflammatory skin conditions, patients in Class 3 had a high prevalence of seizure disorders, and patients in Class 4 had a high prevalence of Asthma. Patients in Class 5 lacked a clear characteristic morbidity pattern, and patients in Classes 6, 7, and 8 had a high prevalence of gastrointestinal issues, neurodevelopmental disorders, and physical symptoms respectively. Subjects generally had high membership probability for a single class (>70%), suggesting shared clinical characterization within the individual groups. We identified patient subtypes with temporal condition patterns that are significantly more common among obese pediatric patients using a Latent Class Analysis approach. Our findings may be used to characterize the prevalence of common conditions among newly obese pediatric patients and to identify pediatric obesity subtypes. The identified subtypes align with prior knowledge on comorbidities associated with childhood obesity, including gastro-intestinal, dermatologic, developmental, and sleep disorders, as well as asthma. Author summary Childhood obesity is a significant public health challenge in the United States. Despite its prevalence, it remains uncertain if pediatric obesity represents a single condition or is composed of different subtypes with possibly different underlying causes. Electronic Health Records (EHRs) are an important source of data that may be analyzed to yield clinical and epidemiological insights to aid in the obesity treatment and prevention. In this paper, we present a study of EHR data that aimed to identify clinically similar subtypes among a population of newly obese pediatric patients. Specifically, we examine whether certain temporal condition patterns associated with childhood obesity incidence tend to cluster together to characterize subgroups of clinically similar patients. We identified eight potential subtypes, differentiated by the prevalence of various diagnoses including respiratory and sleep disorders, inflammatory skin conditions, asthma, and seizure disorders. This work may be used as a foundation for future investigations into pediatric obesity subtypes as well as to inform methodological and clinical research to mine EHR data for potential insights that improve patient health outcomes.