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Published on: November 10, 2017
Longitudinal study on pediatric dyslipidemia in population-based claims database
Jie Li1, Stephen P Motsko, Earl L Goehring
1Degge Group, Ltd, USA. jli@deggegroup.com
Insights
Pediatric lipid testing rates are low, with few children diagnosed or treated for dyslipidemia. Diagnostic codes have low sensitivity, yet associated conditions like obesity, diabetes, and hypertension are common in affected children.
Area of Science:
- Pediatric Health
- Cardiovascular Health
- Medical Informatics
Background:
- Dyslipidemia in children is a growing concern linked to cardiovascular disease.
- Accurate identification and management of pediatric dyslipidemia are crucial for long-term health outcomes.
- Understanding current testing rates and diagnostic code accuracy is vital for improving pediatric care.
Purpose of the Study:
- To determine the frequency of lipid testing in children using US insurance claims data.
- To characterize pediatric dyslipidemia and its associated comorbidities.
- To evaluate the sensitivity of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes for identifying dyslipidemic children.
Main Methods:
- Retrospective cohort study utilizing 2003-2006 claims data from Integrated Healthcare Information Services (IHCIS).
- Comparison of children with laboratory-defined or diagnosis/treatment-defined dyslipidemia against matched controls without dyslipidemia.
- Analysis of comorbidities within specific timeframes before and after dyslipidemia identification.
Main Results:
- Only 7% of children with available lab values underwent cholesterol testing.
- A low percentage (15%) of laboratory-defined dyslipidemic children received a dyslipidemia diagnosis.
- Dyslipidemic children exhibited significantly higher rates of obesity, diabetes mellitus, and hypertension compared to controls.
Conclusions:
- The study highlights a low rate of lipid testing in the pediatric population.
- ICD-9-CM codes demonstrate poor sensitivity in identifying children with dyslipidemia.
- Despite low diagnosis and treatment rates, comorbidities associated with dyslipidemia are prevalent in children.
Purpose:
To examine the rate of lipid testing among children from a large US medical insurance claims database, describe the characteristics of pediatric dyslipidemia, and assess the sensitivity of the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes for identifying dyslipidemic children.
Methods:
This retrospective cohort study used the claims data from the Integrated Healthcare Information Services (IHCIS), for the years 2003-2006. Two study cohorts consisted of children with laboratory-defined and diagnosis/treatment-defined dyslipidemia, respectively. They were compared to age- and gender-matched children without dyslipidemia, with respect to co-morbidities during the 6-month prior to and 12-month after the first dyslipidemic laboratory value or diagnosis/treatment.
Results:
Seven per cent of the children who had laboratory values available in the database had a cholesterol test during the study period. Only 15% of laboratory-defined children (n = 23,475) had a dyslipidemia diagnosis. Cholesterol-modifying medications were rarely prescribed. Substantially more laboratory-defined children than their comparators were obese (8 times), had diabetes mellitus (10 times), or had hypertension (5 times). These co-morbidities were even higher among diagnosis/treatment-defined children.
Conclusions:
The rate of lipid testing among children was low. The ICD-9-CM diagnostic codes showed low sensitivity against laboratory definitions. Though only a small proportion of dyslipidemic children were diagnosed or treated with a medication, co-morbidities associated with dyslipidemia were common.
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