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Evaluation of administrative case definitions for hypertension in Canadian children

Allison Dart1, Alexander Singer2, Rahul Chanchlani3

  • 1Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, Diabetes Research Envisioned and Accomplished in Manitoba, University of Manitoba, FE-009 820 Sherbrook St., Winnipeg, MB, R3A1R9, Canada. adart@hsc.mb.ca.

Scientific Reports
|May 11, 2023
PubMed

Insights

Identifying pediatric hypertension in administrative data is challenging. Combining hospitalization, physician claims, and medication use improves case definition accuracy for disease surveillance.

Area of Science:

  • Pediatric Health
  • Public Health Surveillance
  • Health Informatics

Background:

  • Childhood hypertension is a growing concern requiring effective disease surveillance.
  • Administrative healthcare data offers potential for identifying pediatric hypertension cases.

Purpose of the Study:

  • To assess the validity of various case definitions for identifying pediatric hypertension in administrative healthcare data.
  • To determine the prevalence and clinical characteristics of hypertension in children aged 3-18 years.

Main Methods:

  • Utilized electronic medical record data from the Manitoba Primary Care Research Network (MaPCReN) (2014-2016).
  • Evaluated 18 case definitions combining physician visits (ICD9CM), hospital claims (ICD9CM/ICD10), and antihypertensive medication use.
  • Calculated sensitivity, specificity, and area under the ROC curve for each definition.

Main Results:

  • Identified 241 children with hypertension (prevalence 5.6%).
  • Algorithm sensitivity ranged from 0.18 to 0.51, with specificity from 0.98 to 1.00.
  • Including pharmaceutical records significantly increased sensitivity; definitions incorporating hospitalization, physician claims, or medication showed highest performance.

Conclusions:

  • Administrative data demonstrates high specificity for diagnosing pediatric hypertension but underestimates prevalence.
  • A 2-year data evaluation period is recommended.
  • Alternative data sources are necessary to complement administrative data for comprehensive disease surveillance.

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