title: Validation of a Case Definition for Pediatric Brain Injury Using Administrative Data.
abstract: BACKGROUND
  Health administrative data are a common population-based data source for traumatic brain injury (TBI) surveillance and research; however, before using these data for surveillance, it is important to develop a validated case definition. The objective of this study was to identify the optimal International Classification of Disease , edition 10 (ICD-10), case definition to ascertain children with TBI in emergency room (ER) or hospital administrative data. We tested multiple case definitions.
  
  
  METHODS
  Children who visited the ER were identified from the Regional Emergency Department Information System at Alberta Children's Hospital. Secondary data were collected for children with trauma, musculoskeletal, or central nervous system complaints who visited the ER between October 5, 2005, and June 6, 2007. TBI status was determined based on chart review. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each case definition.
  
  
  RESULTS
  Of 6639 patients, 1343 had a TBI. The best case definition was, "1 hospital or 1 ER encounter coded with an ICD-10 code for TBI in 1 year" (sensitivity 69.8% [95% confidence interval (CI), 67.3-72.2], specificity 96.7% [95% CI, 96.2-97.2], PPV 84.2% [95% CI 82.0-86.3], NPV 92.7% [95% CI, 92.0-93.3]). The nonspecific code S09.9 identified >80% of TBI cases in our study.
  
  
  CONCLUSIONS
  The optimal ICD-10-based case definition for pediatric TBI in this study is valid and should be considered for future pediatric TBI surveillance studies. However, external validation is recommended before use in other jurisdictions, particularly because it is plausible that a larger proportion of patients in our cohort had milder injuries.
authors.affiliation: 1Department of Community Health Sciences and Institute for Public Health.
authors.forename: Jane
authors.initials: J
authors.lastname: McChesney-Corbeil
authors.affiliation: 3Department of Pediatrics,University of Calgary,Calgary,Alberta.
authors.forename: Karen
authors.initials: K
authors.lastname: Barlow
authors.affiliation: 1Department of Community Health Sciences and Institute for Public Health.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.affiliation: 1Department of Community Health Sciences and Institute for Public Health.
authors.forename: Guanmin
authors.initials: G
authors.lastname: Chen
authors.affiliation: 1Department of Community Health Sciences and Institute for Public Health.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
authors.affiliation: 1Department of Community Health Sciences and Institute for Public Health.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jette
mesh_terms: D000293:Adolescent; D000416:Alberta; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D038801:International Classification of Diseases; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
keywords: Brain Injury – Pediatric Health Services; Health Services Research