Adolescent Eating Disorders in Arkansas: 1998 to present

Tracie Pasold, PhD

Principal Investigator
pasoldtraciel@uams.edu

Susan Goolsby, MS, RD, CSSD, LD

Co-investigator
goolsbysl@archildrens.org
501-364-1261

Maria Portilla, MD
Co-investigator
portillamariag@uams.edu

Sponsors:
University of Arkansas for Medical Sciences Department of Adolescent Medicine
Arkansas Children's Hospital, Department of Clinical Nutrition
Introduction and Background

Adolescents with eating disorders face numerous medical

complications that can
severely impact their future health and/or result in death. Cardiac
problems, amenorrhea and osteoporosis are commonly seen in
patients with Anorexia Nervosa. Patients with Bulimia Nervosa are at
risk for electrolyte abnormalities which can result in cardiac
complications, which could be fatal. More prominently are the existing
emotional and behavioral correlates associated with eating disorders
and the comorbidities.
Little is known about Arkansas’ specific data on adolescents and
children and if it differs significantly from national data. More research
is needed to define this patient population so that prevention may be
designed and treatment improved.

Objectives of the Study

The objectives of this study are:

• To examine the incidence and prevalence of adolescent eating disorders among
adolescents in Arkansas treated at Arkansas Children’s Hospital (ACH) Eating
Disorder (ED) Clinic from 1998-2009 and compare that to national data
• To describe the patient population of adolescents with eating disorders treated at
ACH ED Clinic
• To compare multiple medical conditions and how they relate to weight and Body
Mass Index (BMI), more specifically, percent of reference weight
• To determine emotional and behavioral correlates of this population
• Determine if there are particular geographic areas of Arkansas with higher
incidence of ED

Methods

The methodology for this research project will simply entail a review of
the medical record data for each patient evaluated in the eating
disorder program since 1998. Data will be summarized into an Excel
spreadsheet by members of the research team, all of
whom are certified by UAMS as having completed relevant HIPPA
trainings. All identifying information will be separated from the patient
data and replaced with a non−identifying research subject number. All
identifying information will be removed and stored separately in an
encrypted linked table on a separate computer in compliance with
HIPPA regulations. When the database is compiled and all medical data
are linked appropriately, the identifying data kept by the PI will be
destroyed, prior to any analyses of patient data occurring.

Specific data to be collected:

Patients: Race, Gender, Date of Birth, City, State, Zip Code, Type of insurance (Private,
Medicaid or ARKids), Diagnosis at first visit to Eating disorder clinic, Date of first visit
to ED clinic, Date of last visit to ED clinic, Weight, Height, BMI at first and last visit to
ED clinic, Hospital admission dates, Dates and results of Bone density, Dates and results
of Metabolic studies, Status of menses, and BMI when menses resumed. Medical
information obtained at the initial evaluation of the patient in the eating disorder clinic
including complete history and physical examination (weight, height, pulse, blood
pressure) and the following tests which are ordered by the physician per patient at intake
in keeping with the best practices of this clinic population (electrocardiogram (EKG),
resting energy expenditure, bone mineral density, basic metabolic panel, plus magnesium,
phosphorus and calcium, thyroid panel, CVC (red, white, platelet counts), also
psychological data obtained from the evaluation including the clinical interview and the
Eating Disorder Inventory, children's depression inventory, and revised children's
manifest anxiety self report measures.

Initial statistical design and plan:

SPSS will be utilized to perform analyses on that data. Descriptive and spearman
corelational statistics will be run on all variables to explore and identify important
relationships between variables. Analysis of variance will be run on related variables to
determine significance of the relationship between the variables.

Specific elements of the PHI:

Patients: Race, Gender, Date of Birth, City, State, Zip Code, Type of insurance (Private,
Medicaid or ARKids), Diagnosis at first visit to Eating disorder clinic, Date of first visit
to ED clinic, Date of last visit to ED clinic, Weight, Height, BMI at first and last visit to
ED clinic, Hospital admission dates, Dates and results of Bone density, Dates and results
of Metabolic studies, Status of menses, and BMI when menses resumed. Medical
information obtained at the initial evaluation of the patient in the eating disorder clinic
including complete history and physical examination (weight, height, pulse, blood
pressure) and the following tests which are ordered by the physician per patient at intake
in keeping with the best practices of this clinic population (electrocardiogram (EKG),
resting energy expenditure, bone mineral density, basic metabolic panel, plus magnesium,
phosphorus and calcium, thyroid panel, CVC (red, white, platelet counts), also
psychological data obtained from the evaluation including the clinical interview and the
Eating Disorder Inventory, children's depression inventory, and revised children's
manifest anxiety self report measures.

The plan to protect the identifiers from improper use or disclosure:

PHI will be abstracted from medical records. The medical record will contain patient
identifiers. As the information is abstracted from the medical record, a unique number not
associated with the patient identity will be assigned to that subject's data, and the
identifying information of the patient will be kept separately in an encrypted linked table
on a separate computer from the patient data being examined for this research study.

The plan will be to destroy the identifiers at the earliest opportunity consistent with the
conduct of research, unless there is a health or research justification for retaining the
identifiers or retentions is required by law: All patient identifiers will be destroyed once
the patient data from the medical records are linked by a unique non-identifying number.
No analysis of patient data will occur until all patient information is de-identified.