Longitudinal study on pediatric dyslipidemia in population-based claims database.
OBJECTIVE
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.
Li
Jie
J
Degge Group, Ltd, USA. jli@deggegroup.com
Motsko
Stephen P
SP
Goehring
Earl L
EL
Vendiola
Ruby
R
Maneno
Mary
M
Jones
Judith K
JK
D000293:Adolescent; D002648:Child; D002784:Cholesterol / Q000097:blood*; D016208:Databases, Factual; D050171:Dyslipidemias / Q000097:blood* / Q000145:classification* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D038801:International Classification of Diseases / Q000592:standards*; D008137:Longitudinal Studies; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D002784:Cholesterol