Longitudinal study on pediatric dyslipidemia in population-based claims database

Purpose 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. Copyright © 2009 John Wiley & Sons, Ltd.