โก Quick Summary
A recent study evaluated the integration of weight management into asthma care for patients with comorbid obesity, revealing that only 12.6% of encounters documented obesity management. This highlights a significant gap between clinical guidelines and actual practice, suggesting opportunities for improvement in patient outcomes.
๐ Key Details
- ๐ Dataset: 17,658 outpatient encounters involving 8,992 patients
- ๐งฉ Specialties analyzed: Primary care, allergy/immunology, and pulmonary care
- โ๏ธ Technology: GPT-4o, a large language model for documentation analysis
- ๐ Key finding: Only 12.6% of encounters included obesity management in asthma care
๐ Key Takeaways
- ๐ Low integration: Obesity management is infrequently addressed in asthma care.
- ๐จโโ๏ธ Specialty differences: More frequent in subspecialty settings (11.0%) compared to primary care (1.6%).
- ๐ Predictors: Male sex, middle age, higher BMI, and pulmonology care increased the odds of obesity management.
- ๐ Oral steroids: Use of oral steroids decreased the likelihood of obesity management documentation.
- ๐โโ๏ธ Common strategies: Exercise and general weight counseling were frequently noted.
- ๐ค GPT-4o performance: Demonstrated robust capabilities in analyzing clinical documentation.
- ๐ Study period: Data collected from January 2020 to September 2023.
๐ Background
The relationship between obesity and asthma is well-established, with obesity recognized as a significant risk factor for asthma exacerbations. Current asthma guidelines advocate for weight reduction as a critical component of asthma management. However, the extent to which healthcare providers incorporate weight management into routine asthma care remains unclear, necessitating further investigation.
๐๏ธ Study
This study analyzed outpatient encounter notes from a large health system, focusing on patients diagnosed with both asthma and obesity. By utilizing the advanced capabilities of GPT-4o, researchers assessed the documentation of asthma and obesity management strategies across various specialties, aiming to identify how well these two aspects of care are integrated.
๐ Results
The analysis revealed that only 12.6% of the encounters documented any form of obesity management as part of asthma care. Notably, encounters in subspecialty settings showed a higher integration rate (11.0%) compared to primary care settings (1.6%). Factors such as male sex, middle age, and higher education levels were associated with increased odds of obesity management being documented, while the use of oral steroids was linked to decreased odds.
๐ Impact and Implications
The findings from this study underscore a critical gap in the management of patients with comorbid asthma and obesity. With only a small fraction of encounters addressing weight management, there is a clear need for healthcare providers to align their practices with established guidelines. Improving the integration of obesity management into asthma care could lead to better health outcomes for patients, highlighting an actionable opportunity for healthcare systems to enhance their approach to chronic disease management.
๐ฎ Conclusion
This study illustrates the urgent need for improved integration of weight management in asthma care for patients with obesity. The low documentation rates indicate a disconnect between clinical guidelines and practice, suggesting that healthcare providers must prioritize weight management strategies to enhance patient outcomes. Continued research and training are essential to bridge this gap and ensure comprehensive care for affected individuals.
๐ฌ Your comments
What are your thoughts on the integration of weight management in asthma care? Let’s discuss! ๐ฌ Share your insights in the comments below or connect with us on social media:
Management of patients with comorbid asthma and obesity: A large language model evaluation of clinical documentation.
Abstract
BACKGROUND: Obesity is a well-known asthma risk factor, and weight loss benefits asthma outcomes. Asthma guidelines recommend weight reduction as part of care; however, provider practices are not known.
OBJECTIVE: To evaluate if weight management is integrated into routine asthma care for patients with comorbid obesity.
METHODS: We analyzed outpatient encounter notes from patients with both asthma and obesity seen by primary care, allergy/immunology, or pulmonary providers at a large health system between January 01, 2020, and September 30, 2023. Notes were extracted from electronic health records for visits with a primary asthma diagnosis. Using GPT-4o, a large language model (LLM), we assessed documentation of: (1) asthma management; (2) obesity management; (3) integration of obesity management into asthma care; (4) specific weight management strategies. Inclusion rates were compared across specialties, and encounter-level predictors were identified. Chart review evaluated GPT-4o’s performance.
RESULTS: Of 17,658 encounters (N=8992 patients), only 12.6% included obesity management as part of asthma care, more frequently in subspecialty (11.0%) than in primary care (1.6%) settings. In adjusted models, male sex, middle age, higher body mass index, higher education, and pulmonology care increased odds of an encounter with obesity management linked to asthma care; oral steroid use decreased the odds. Obesity management strategies differed by specialty, though exercise and general weight counseling was common. GPT-4o demonstrated robust performance.
CONCLUSION: LLM evaluation of >17,000 encounters demonstrate that, in contrast to guidelines, weight management is infrequently addressed in asthma care. These results highlight actionable opportunities to improve asthma outcomes.
Author: [‘Olayiwola O’, ‘Yang Z’, ‘Stein D’, ‘Wang L’, ‘Foer D’]
Journal: J Allergy Clin Immunol Pract
Citation: Olayiwola O, et al. Management of patients with comorbid asthma and obesity: A large language model evaluation of clinical documentation. Management of patients with comorbid asthma and obesity: A large language model evaluation of clinical documentation. 2025; (unknown volume):(unknown pages). doi: 10.1016/j.jaip.2025.10.004