QHR Product Ideas

Hello there,

Many thanks for all the work you do in keeping the eMR in its very good running condition, and thus immensely helping patient care and outcomes.

This is to request that you consider adding a native calculator/tracker for the Waist Circumference to Height Ratio, just as you have a native BMI calculator/tracker.

As you are aware, WHtR has been shown to be a very strong, non-sex specific CVD marker, and superior to BMI or waist circumference alone in assessing CVD risk in multiple meta analyses spanning across hundreds of thousands to millions of patients. It does not need to be corrected for sex or ethnicity and works especially well in catching central adiposity in those with a BMI below 30. As a risk tool, the universal BMI has essentially been superseded and we need to catch-up clinically. A few example studies are listed below to buttress this point:

"Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012 Mar;13(3):275-86. doi: 10.1111/j.1467-789X.2011.00952.x. Epub 2011 Nov 23. PMID: 22106927."

"Savva SC, Lamnisos D, Kafatos AG. Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis. Diabetes Metab Syndr Obes. 2013 Oct 24;6:403-19. doi: 10.2147/DMSO.S34220. PMID: 24179379; PMCID: PMC3810792."

We look forward to your expedited consideration of this very important request. Thank you again for your commitment to the best care for our populations.

Highest regards,

Victor Obiora, MD.