Identifying pediatric hypertension in observational data: comparing clinical and claims cohorts in real-world data

Area of Science:

• Public Health
• Pediatric Cardiology
• Health Informatics

Background:

• Pediatric hypertension is a growing concern.
• Accurate identification of pediatric hypertension in real-world data is crucial for research and clinical practice.
• Existing data sources may not fully capture the prevalence or severity of pediatric hypertension.

Purpose of the Study:

• To compare clinical and claims-based definitions of pediatric hypertension.
• To assess the concordance between clinical diagnosis and insurance claims for hypertension in children and adolescents.
• To evaluate the association between claims-based hypertension and disease severity or mortality.

Main Methods:

• Retrospective public health surveillance using data from 2006-2016.
• Utilized the US Food and Drug Administration's Sentinel System with 7 integrated delivery systems.
• Identified pediatric patients (3-17 years) using clinical and claims-based definitions for hypertension.

Main Results:

• Out of over 3.7 million pediatric patients, 9% of children and 8.7% of teens met the clinical definition of hypertension.
• Only 2.2% of clinically hypertensive children and 7.3% of teens had corresponding hypertension claims.
• Claims-based hypertension was associated with greater disease severity and higher all-cause mortality.

Conclusions:

• Insurance claims data under-capture pediatric hypertension.
• Claims-based hypertension may serve as a marker for increased disease severity.
• Researchers must consider coding practices when using real-world data for pediatric hypertension studies.