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Prevalence of Inflammatory Bowel Disease Among Patients with Autism Spectrum Disorders
Finale Doshi-Velez1, Paul Avillach, Nathan Palmer
1*School of Engineering and Applied Science, Harvard University, Cambridge, Massachusetts; †Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts; ‡Inflammatory Bowel Disease Center, Boston Children's Hospital, Boston, Massachusetts; §Wake Forest Baptist Medical Center, Winston-Salem, North Carolina; and ‖Aetna, Inc., Hartford, Connecticut.
Background:
The objective of this study was to measure the prevalence of inflammatory bowel disease (IBD) among patients with autism spectrum disorders (ASD), which has not been well described previously.
Methods:
The rates of IBD among patients with and without ASD were measured in 4 study populations with distinct modes of ascertainment: a health care benefits company, 2 pediatric tertiary care centers, and a national ASD repository. The rates of IBD (established through International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes) were compared with respective controls and combined using a Stouffer meta-analysis. Clinical charts were also reviewed for IBD among patients with ICD-9-CM codes for both IBD and ASD at one of the pediatric tertiary care centers. This expert-verified rate was compared with the rate in the repository study population (where IBD diagnoses were established by expert review) and in nationally reported rates for pediatric IBD.
Results:
In all of case-control study populations, the rates of IBD-related ICD-9-CM codes for patients with ASD were significantly higher than that of their respective controls (Stouffer meta-analysis, P < 0.001). Expert-verified rates of IBD among patients with ASD were 7 of 2728 patients in one study population and 16 of 7201 in a second study population. The age-adjusted prevalence of IBD among patients with ASD was higher than their respective controls and nationally reported rates of pediatric IBD.
Conclusions:
Across each population with different kinds of ascertainment, there was a consistent and statistically significant increased prevalance of IBD in patients with ASD than their respective controls and nationally reported rates for pediatric IBD.
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