Pediatric Case Definition
Arthritis Case Definition (Pediatric) for Estimating Population Prevalence
Pediatric Arthritis Case Definition for Surveillance
In response to Congressional language in the draft Arthritis Prevention Control and Cure Act of 2004, which directed CDC to estimate the prevalence of childhood arthritis, the Arthritis Program and the American College of Rheumatology (ACR) cohosted a 1-day summit of experts in surveillance, rheumatologists, and key stakeholders in December 2004 to consider the options available for conducting surveillance of pediatric arthritis and making a standardized pediatric case definition for surveillance purposes. It was appreciated at the meeting that considerable disagreement exists among experts about what is a clinical case and how many cases there are. Following that meeting, the Arthritis Program worked with the American Academy of Pediatrics (AAP), ACR, and other stakeholders to refine the approach to surveillance and the case definitions.
After a year and a half process of gathering and considering input, testing possibilities, and consulting with key constituents and partners, in June 2006 the CDC Arthritis Program finalized a case definition for ongoing surveillance of pediatric arthritis and other rheumatologic conditions. The definition is based on selected ICD-9CM diagnostic codes [11K] found in health care and other diagnostically-based data systems. These codes are applied to national ambulatory care surveys used to estimate both the number of ambulatory health care encounters and the number of children with pediatric arthritis and other rheumatologic conditions. The prolonged efforts at developing a surveillance case definition revealed much variation about what consultants felt should be counted as a case pediatric arthritis or other rheumatologic conditions. In response, CDC has also generated estimates for conditions that had been requested but not included in the case definition.
Sacks JJ, Helmick CG, Luo YH, Ilowite NT, Bowyer S. Prevalence of and annual ambulatory health care visits for pediatric arthritis and other rheumatologic conditions in the United States in 2001–2004. Arthritis Care Res 2007;57(8):1439–1445. abstract