title: Accuracy and usefulness of the HEDIS childhood immunization measures.
abstract: OBJECTIVE
  With the use of Centers for Disease Control and Prevention (CDC) immunization recommendations as the gold standard, our objectives were to measure the accuracy ("is this child up-to-date on immunizations?") and usefulness ("is this child due for catch-up immunizations?") of the Healthcare Effectiveness Data and Information Set (HEDIS) childhood immunization measures.
  
  
  METHODS
  For children aged 24 to 35 months from the 2009 National Immunization Survey, we assessed the accuracy and usefulness of the HEDIS childhood immunization measures for 6 individual immunizations and a composite.
  
  
  RESULTS
  A total of 12 096 children met all inclusion criteria and composed the study sample. The HEDIS measures had >90% accuracy when compared with the CDC gold standard for each of the 6 immunizations (range, 94.3%-99.7%) and the composite (93.8%). The HEDIS measure was least accurate for hepatitis B and pneumococcal conjugate immunizations. The proportion of children for which the HEDIS measure yielded a nonuseful result (ie, an incorrect answer to the question, "is this child due for catch-up immunization?") ranged from 0.33% (varicella) to 5.96% (pneumococcal conjugate). The most important predictor of HEDIS measure accuracy and usefulness was the CDC-recommended number of immunizations due at age 2 years; children with zero or all immunizations due were the most likely to be correctly classified.
  
  
  CONCLUSIONS
  HEDIS childhood immunization measures are, on the whole, accurate and useful. Certain immunizations (eg, hepatitis B, pneumococcal conjugate) and children (eg, those with a single overdue immunization), however, are more prone to HEDIS misclassification.
authors.affiliation: Division of Quality and Safety, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. dbundy@jhmi.edu
authors.forename: David G
authors.initials: DG
authors.lastname: Bundy
authors.forename: Barry S
authors.initials: BS
authors.lastname: Solomon
authors.forename: Julia M
authors.initials: JM
authors.lastname: Kim
authors.forename: Marlene R
authors.initials: MR
authors.lastname: Miller
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007114:Immunization / Q000592:standards*; D007223:Infant; D017053:Infection Control / Q000379:methods* / Q000592:standards*; D008297:Male; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014481:United States