The Burden of Biopsy-Proven Pediatric Celiac Disease in Ontario, Canada: Derivation of Health Administrative Data Algorithms and Determination of Health Services Utilization

Abstract

Introduction: The main objective of this thesis is to develop an algorithm to accurately identify cases of biopsy-proven Celiac Disease (CD) in children aged 6 months-14 years old from Ontario health administrative data. Method: CD cases diagnosed in 2005-2011 were identified from CHEO, and linked to the health administrative data to serve as reference for algorithms derivation. Algorithms based on outpatient physician visits for CD plus endoscopy billing code were constructed and tested. Results: The best algorithm selected based on performance from derivation study and clinical expertise consisted of an OHIP-based endoscopy billing claim followed by 1 or more adult or pediatric gastroenterologist encounters after the endoscopic procedure. The sensitivity, specificity, PPV, and NPV for the algorithm were 70.4%, >99.9%, 53.3% and >99.9% respectively. Conclusion: Study results suggest that the currently available Ontario health administrative data is not suitable for identifying incident pediatric CD cases.