Enhancing Health Surveillance: Validation of a Novel Electronic Medical Records-Based Definition of Cases of Pediatric Type 1 and Type 2 Diabetes Mellitus

Objectives: To compose and validate an electronic medical records-based case definition for pediatric diabetes in primary care. Methods: Data from the electronic medical records of 221 primary care providers participating in the Manitoba Primary Care Research Network were extracted from April 1, 1998, to March 31, 2015. We assessed agreement among the 3 case definitions of pediatric diabetes and compared the performance of each with the clinical database of the Manitoba Diabetes Education Resource for Children and Adolescents. Results: Our reference dataset included 41,055 pediatric patients. Electronic medical records-based case definitions, which included billing records, health conditions lists, prescription records and laboratory results, showed substantially higher sensitivity compared to the administration-based case definition that relied on billing and prescription records (96.9% and 94.9% vs 48.5%). Our study suggests a higher prevalence of pediatric diabetes in Manitoba than was previously reported through administration-based case definitions or in patients whose data were captured in the Manitoba Diabetes Education Resource for Children and Adolescents clinical database. Conclusions: We describe a novel method of calculating the prevalence of pediatric diabetes in a primary care population. This case definition will improve the surveillance of pediatric diabetes and enhance service planning and the development of strategies to support prevention and management. (C) 2019 Canadian Diabetes Association.